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FROM October 21st, 2020

I am heartbroken, along with millions of Nigerian mothers, grandmothers, and women, to have borne witness to the killing of a still uncounted number of our nations young citizens, protesting peacefully, holding the flag of our nation, behind a barrier, at the Lekki Tollgate, on the October 20th, 2020.

Our nations young citizens were shot in cold blood as many of them sat on the ground singing our national anthem. They were shot by their own army, by soldiers whose job it is to protect them. And they were shot in the complete absence of members of Nigerias Police Force, whose job it likewise is to protect the lives and property of civilians, and who have sadly proven themselves to be under-trained, under-equipped and thus over-strained in times of crisis, incapable and unwilling to exercise the standard stewardship of crowd control.

It is no secret that the peaceful protests concern the glaring impunity and militarization of the Nigeria Police Forces Special Anti-Robbery Squads brutality towards young Nigerians which had reached the fever pitch of a public safety emergency, culminating in widespread reports of intimidation, harassment and extrajudicial killings – and that young people had organically risen, together, yet leaderless, to peacefully oppose this constant threat to their normal lives. In the last 24 hours, these protests were visibly disrupted in several cities by armed thugs. While the latter appeared to have the backing of the organs of state, in some instances they even killed innocent policemen. Last night, the Nigerian Army came out of its expansive barracks to controla group of protesters on the Lekki Bridge Toll Gate, linking two of Lagoss most exclusive residential communities. The young people had gathered peacefully behind a barrier as can be seen from all manner of media footage. The army fired live rounds not into the air but into the crowd, at close range, killing several and injuring an indeterminate number – in a flagrant contravention of the protocols of the International Covenant on Civil and Political Rights and the Rome Statute of the International Criminal Court. Moreover, in so doing the commanding officer ignored the human rights of freedom of speech and assembly, and the right to protest peacefully, despite Nigeria being a signatory to the ICCPR.

My ears have rung with the mournful blare of howling sirens ever since, as ambulances contributed by private hospitals made their way, with difficulty through the curfews and against the odds, to the scene of bloodshed and death, to try to provide care, for the injured, and the murdered dying.

Behind every statistic of inhumanity and injustice is a story, and behind each human being and young citizen is a family. The Nigerian flag, standing for peace, progress and unity, has been indelibly stained with the blood of our young citizens, who themselves were protesting against the SARSs notorious record of thousands of incidents of rape, torture, un-anaesthetised testicular castrations, and extra-judicial killings, not to mention wanton acts of theft – the very crime it was established to curb. As a mother and grandmother, and I know I am not alone, I fully understand the determination of the youth movement advocating peacefully to #EndSARS and #ReformPoliceNG in Nigeria. At the same time, as a patriot, I am deeply concerned by the disruptions to the nation's safety, peace and productivity.

To build a nation, youth empowerment and youth development should be supported as a process where young people are encouraged to take charge of their lives. They should be supported as they address their situation, transform their consciousness through their own beliefs, values, and attitudes, and take action in order to improve their lives. Youth empowerment is a gateway to much needed inter-generational equity, civic engagement and democracy building.

Many have called for our nations youth to sheathe their swords, appoint leaders and representatives to embark on dialogue with belatedly yet urgently assembled government commissions – but we must recognize this incontrovertible fact: the youth never had any swords.

All they had were their voices, hopes, aspirations and patriotism. If their words were swords, then we know how frightening words must be for the current administration.  How can an invitation to sit down at a table for proposed dialogue be so frightening as to be simultaneously accompanied by fatal aggression and bloodshed? Who called our army out to kill, maim and injure our nations youth – all of whom eagerly and enthusiastically give a year of their efforts and energies to our mandatory National Youth Service Corps.

It is a travesty, and a crime, that young Nigerians should be shot in cold blood simply because they empowered themselves to develop and declare five wishes to live, work and prosper with respect and rights, as occurred on 20th October, 2020. Silence is not an acceptable answer amidst the public calls for dialogue, and Nigeria must hold itself to account.

I urge Nigerian officials and the Nigerian military, to immediately cease the violent and in part fatal crackdown on peaceful protesters in Nigeria. I urge the Nigerian Police to redouble its discipline to safely secure lives and property. My heart is broken along with all those who have lost a loved one in the violence. I ask the world and the diplomatic community to stand with Nigerians who are peacefully demonstrating for police reform and an end to injustice and corruption in our democracy.

I thank the churches and religious leaders, who threw open their parish doors to offer our nations young citizens refuge and have sought to encourage the government to engage in a good-faith dialogue with civil society. It is time to address these long-standing grievances and work together for a just, inclusive, peaceful and united Nigeria. I thank the hospitals that have worked tirelessly and free of charge to do what they could to treat the gunshot wounds many young people had. It was an act of profound solidarity at a time when our nations officials abandoned our young. For the blood of Nigerias young citizens that has been spilled, for daring to raise their voices to peacefully demand a better future of inter-generational equity and accountability for all, we must do our utmost to ensure that their blood was not shed in vain. Our nation just celebrated 60 years of independence, autonomy, agency and governance. We remain in measured hope as we pray that our young citizens continue to surpass us in their achievements, and we will not forget.

FROM October 15th, 2020

We’re all scrambling to wash our hands, but handwashing isn’t reaching women who are the backbone of societies.

How poignant it is that Global Handwashing Day, during the greatest pandemic in modern history, falls on the same day as International Day of Rural Women? Rural women are at once the backbone of our society and the most stifled by a lack of access to water, sanitation and hygiene resources. Globally, throughout shutdowns and lockdowns, rural women are continuing to do the work to provide the sustenance that each and every one of us needs to be able to survive the day. Rural women are predominant in the field of agriculture (globally, one in three employed women works in agriculture, which rings true to Nigeria as well). Rural women protect our food security and support our nutrition, manage our land and subsequently our natural resources. They are on the frontline when the elements that support our homesteads are threatened, as they are most responsible for unpaid domestic care work.  At the same time, the most prominent advice that we have to prevent the spread of the pandemic is to wash our hands. So while some companies alter their supply chains to create hand sanitizer and new handwashing stations are installed in developed countries’ public spaces, the fact remains that over 2 billion people globally lack basic access to handwashing facilities, primarily in developing countries like Nigeria. The lack of access to WASH facilities for handwashing is most prevalent in rural communities: in Nigeria, 70% of households in rural communities do not have access to improved water supply. These rural communities are likely to rely on water sources such as rivers, streams, ponds and unprotected wells; and in 80% of households without piped water, they rely on women and girls for water collection. Water from rivers, streams and ponds are susceptible to water borne diseases such as typhoid fever, cholera, dysentery, malaria parasites etc, and ultimately, unsafe drinking water, inadequate availability of water for hygiene, and lack of access to sanitation together contribute to about 88% of deaths from diarrheal diseases. While our world scrambles to think of innovative new ways to implement the World Health Organisation’s new guidance on hand hygiene to protect against Covid-19, we in Nigeria must remember that it is rural women who must be prioritised first. As the backbone of our country and the people most responsible for ensuring our sustenance from food and water, their access to handwashing resources is of utmost importance. What’s more: soap is not expensive, but a lack of soap is VERY expensive: it costs the world 134,147,060,000,000 Naira. It is time for Nigeria to invest in hygiene, and country-led programmes to accelerate progress and sustainable impact for the people who lack basic handwashing facilities. My Wellbeing Foundation Africa Mamacare midwives help remedy the issue in Nigeria by going deep into rural communities, health facilities and schools to ensure water, sanitation and hygiene. We call our dedicated interlocutors 'Sanitation Angels,' as they deliver key knowledge and best practice techniques at public and private primary, secondary and tertiary health facilities across Nigeria. Another organisation doing an amazing job aiming to reach rural women is ACWW, who is hosting a Survey on Living Conditions Of Rural Women, which I ask that you share with rural women in your life.  

FROM October 12th, 2020

The anguished scenes coming from our beloved nation Nigeria, of peaceful young protesters being forcefully dispersed, arrested and even injured and killed, are cause for sobering concern, even as many have noted the announcement that the SARS is to be immediately disbanded. The scenes speak to the state of the nation's wellbeing, and what affects one citizen, affects us all. The Economic and Social Research Council, which supports police reform in Nigeria, has assessed that between 2015 and 2019, over 40,000 lives were lost to violent crime, civil unrest and banditry, over 1,000 police officers died or were missing in the line of duty, over N600 billion Naira is estimated to have been lost to violent unrest and crime, while thousands of complaints have been filed to and by the police. Among those is a complaint regarding the molestation of a group of 70 women alleged to be sex-workers in Abuja in 2018 and 2019. That these women were treated by the authorities as less than human is at once a grave offense to their dignity and at the same time, an all-too-common occurrence. Our commitments and endorsement of United Nations Resolution 1325 specifically call for a reduction on violence against the female gender particularly because it is ultimately women and girls who bear the brunt in conflict. That our police system so blatantly flies in the face of internationally recognised orders that promote the healthy development of a country is antithetical to its purpose and existentially damaging to our nation's progress. It is poignant that yesterday was International Day of the Girl, and it was notable that I saw images of steadfast female activist Aisha Yesufu insist on social justice, and so many other young women rising to provide representation and relief. I see hope and practical expressions of loyalty to our nation's ideals in our women and youth. Our young citizens have made five requests of our nation's leaders:

  •  Immediate release of all arrested protesters
  • Justice for all deceased victims of police brutality and appropriate compensation for their families
  • Setting up an independent body to oversee the investigation and prosecution of all reports of police misconduct within 10 days
  • In line with the new Police Act, psychological evaluation and retraining (to be confirmed by an independent body) of all disbanded SARS officers before they can be redeployed
  • Increase police salary so that they are adequately compensated for protecting lives and property of citizens.
I urge decision-makers to listen to the voices and experiences of young citizens to chart a positive path forward in ending brutality, initiating reform towards restoring rights, civil liberties, safety, security and peace.

FROM October 11th, 2020

The empowerment of girls directly relates to their ability to obtain a quality of education, and ultimately, the rise of girls directly correlates with a nation’s ability to sustainably develop. 

On International Day of the Girl Child in the middle of the global pandemic which has seen the project of ensuring the systems to empower women and girls plummet, I am lending my voice to our equal future by celebrating girls' right to education. We must eliminate all forms of discrimination against girls and build the will of leaders to commit to a course of actionand an intentional and deliberate community of practicethat helps girls to rise, from respectful care from birth and the cradle, to productive and prosperous age. Girls face multiple challenges purely because of their age and gender. Around 62 million girls around the world have no access to education and less than 40% of countries provide girls and boys with equal access to education. From being denied an education to experiencing teenage pregnancies and being forced into child marriage, girls face a myriad of obstacles that prevent them from realising their full potential.  In Nigeria, 10.5 million of the country’s children aged 5-14 years are not in school, and in some states in the north, more than half of the girls are not enrolled in schools at all. With the impact of Covid-19, children who were already most at risk of being excluded from a quality education have been most affected. Girls are more likely to be pulled out of school to take care of the family at home during the pandemic, and studies have also found girls’ access to mobile internet is 26% lower than for their male peers. Researchers found that previous epidemics have forced more girls than boys to halt their studies, which impacted economic prospects for a generation of young women. Yet we know that when a girl is educated, she is enabled, empowered and engendered to realise her full potential.  This was why, in my subnational advocacy as the First Lady of Kwara State from 2003 to 2011, I had deliberately and historically made it a point of principle and action to lend my voice and effort in mobilising women's groups and cooperatives to advocate strongly for the retention of the girl child in education. I also advocated for the domestication and implementation of Child Rights legislation through the Kwara State Child Rights Law of 2007, the Kwara State Safe Maternity Services Law of 2010, a strategic partnership with NAPTIP to strengthen anti trafficking protocols, and the establishment of a framework to deliver universal health coverage through the Kwara State Community Health Insurance Scheme. By the time I hosted Nigeria’s first Child Rights Conference in 2010, it was clear that the results went deeper than benefits to education, health and societal wellbeing that earned Kwara State the UNICEF accolade of being "fit for a child,” as the first of Nigeria's 19 northern states to reach this ambitious standard. By 2011, Kwara State was not only recognised as the state whose girls were the oldest in the nation at their first sexual encounter, but also recorded over 35% of women in elective and appointive positions at federal and state levels, including several Senior Ministers of the Federal Republic of Nigeria, namely Amina Ndalolo, Halima Tayo Alao, Olufunke Adedoyin, and an ambassador, Nimota Akanbi. Nationally, I lent my voice, effort and resources to the successful passage of the Violence Against Persons Prohibition Law, the rights of women to inheritance, the Breastmilk Substitutes Law, legislation to protect students in tertiary institutions from sexual harassment , and raising an evidenced body of analysis to challenge a perplexing constitutional amendment aimed at treating a married minor as an adult for renunciation of citizenship. The journey has also registered disappointments, significantly, the failure of Nigeria’s Gender Equality and Opportunities Bill. Unsurprisingly, the effects of conflict and unrest have been sharply highlighted in Nigeria’s North-East since the 2014 abductions of the Chibok Girls, and many more victims of enforced disappearances, necessitating the development of a dedicated strategy for the prevention of sexual violence in conflict PSVI, in support of United Nations Resolution 1325 though engaging globally with the United Kingdom-France PSVI Consultations and UNWomen African Women Leaders Network, and regionally with the African Union and Ecowas Consultations.  Health and wellbeing are indivisibly intertwined with educational opportunities in powering a healthy, prosperous and productive future, so to raise a pipeline of confident girls, the percolation of tree-top advocacy must cascade to frontline grassroots action, thus My Wellbeing Foundation Africa knows that an expanded investment in girls’ education, in providing personal social and health education not only equips girls with skills and knowledge to grow and prosper, but it helps their siblings, family, and wider community to thrive as well. Girls who stay in school are more likely to support themselves, look after their health, avoid early marriage and early pregnancy and contribute more to society. That’s why one of the ways we support the Girl Declaration and a girls' right to education is through our primary schools and adolescent PSHE WASH program sessions. Our approach is unique: powered by the professional interlocutory capacities of our groundforce of professionally qualified community midwives, we work directly with schools and communities to help them create a better and healthier future for their children and themselves. While the confidence to initiate and cascade innovation may come from being fortunate to be born in circumstances where the opportunities to rise and thrive are guaranteed, I am encouraged that we can build a community of better practice for all. That notion is evocative of this picture of myself and two childhood friends from 1969, when we had just celebrated what the world now recognises to be a key milestone and measurement of development and demographic functionality: the age of 5 years. The milestone underscores the importance of the goal that every girl may survive and thrive, with her full complement of rights, to transform her future, and the collective rise of girls and women in our nation.    [caption id="attachment_1229" align="alignnone" width="768"] Left: Sefi Atta, author and playwright
Middle: HE Toyin Saraki
Right: Obi Okigbo, architect and artist[/caption] Today, Sefi Atta, to my left, (born January 1964) is a prize-winning Nigerian-American author, playwright and screenwriter, who qualified as a Chartered Accountant in England, a Certified Public Accountant in the United States, and holds a Master of Fine Arts in Creative Writing. Her books have been translated into many languages. Sefi was a juror for the 2010 Neustadt International Prize for Literature, and has received several literary awards for her works, including the 2006 Wole Soyinka Prize for Literature in Africa and the 2009 Noma Award for Publishing in Africa. In 2015, a critical study of her novels and short stories, Writing Contemporary Nigeria: How Sefi Atta Illuminates African Culture and Tradition, was published by Cambria Press. Also a playwright, her radio plays have been broadcast by the BBC and her stage plays have been performed and published internationally. Equally, Obiageli Annabel Zeinab Okigbo (born 1964 Ibadan), grew up in Nigeria until the age of 16. She continued her studies in Kent, then graduated from Oxford Brooks University with a BA in Architecture and pursued her post-graduate studies at the Architectural Association School of Architecture in London. She practiced architecture in London, Rome and Paris until 1994. In 1995 she moved to Brussels where she now lives. Expanding her reach into the visual arts, she began developing her work on a theoretical level through painting and has consequently exhibited in Nigeria, the United Kingdom, Dubai and Belgium including two major solo exhibitions in Lagos, 2003 and London, 2007. Obi is President of the Christopher Okigbo foundation which she established in 2005, which is tasked with researching and preserving the legacy of Christopher Okigbo, poet (1932-1967). These women are the exemplar that the female gender, given gender-equal and equitable opportunities, will rise. By investing in girls, every girl can be that example. With an eye for achieving all that we have set out for the United Nations’ Decade of Delivery, we must embed the notion and girl declaration that girls’ progress means Sustainable Development Goals’ progress. Before, during and after crises like the pandemic, we must stand with her: we must build a skilled girl force and support that girl force to be unscripted and unstoppable, and lend our voice to our equal future. On International Day of the Girl Child, and always, we must respect and protect her mind, her vision, her spirit. Empowered and educated, girls can do anything they set their minds to. Lets encourage girls to shape the world they want to live in, achieving generation equality, and our planet 50/50 goals, now and today.

FROM October 5th, 2020

This weekend, the Wellbeing Foundation Africa's MamaCare Antenatal & Postnatal Education Program's Whatsapp Maternity Support had the honour to be featured in British Vogue Magazine's Forces For Change October Edition about their work reaching every last mile to care and counsel mums, babies, and their families. I am so proud of their embracing the promise of technology to democratize access to accurate information from conception and the cradle, to age. MamaCare’s WhatsApp world is far from your typical online talkfest. It’s a safe space for pregnant women and new mums in Nigeria to connect, commiserate, congratulate, and voice their honest concerns — including the stuff deemed uncomfortable or taboo — knowing they can count on getting a prompt, accurate response in return. Our midwives, sometimes referred to endearingly as “Mama” by their group members, field questions about everything from breast feeding and nutrition to pregnancy sex and postpartum spotting. By harnessing the power of digital communication I believe that MamaCare will amplify its impact. What’s currently reaching 8,000 mothers a month, can soon evolve into well over 200,000. And with about seven million babies born in Nigeria each year and our goal of providing every single one of them and their families with a safe delivery and quality care, the new WBFA chatbot will be a major step in fast-tracking that ambition. Our tech is going to underpin our frontline. We want to be able to deliver lessons, immunisation reminders, nutrition advice, all by WhatsApp. If something as obtainable as WhatsApp has the capacity to improve medical outcomes for Nigeria’s most disadvantaged women through the diffusion of reliable information, then the world might not be as far from widespread healthcare reform as we once thought. As the developers of a wide range of home and health facilities based health records, the Wellbeing Foundation Africa believes that the role of data collation and analysis is crucial to the evolution of egalitarian healthcare systems. When we’re at a crossroads and we’re not sure what to do, data, if it’s openly and freely available, can lead us forward, hovwever we can’t access data if we’re not accessing the promise and realities of technology. I’m hoping that the WBFA’s use of technology will add this extra layer to all of our programming, and democratise it. Read more about my Forces For Change interview: WhatsApp Is The Key To Democratising Global Healthcare>>

FROM October 1st, 2020

During my childhood in the 1960's, I remember singing our Independence Anthem confidently in the affirmation that though our tribes and tongues may differ, we stand in brotherhood, proud to serve our sovereign motherland. Our flag is a symbol that truth and justice should reign, and our collective dream of being able to hand on to our children, a banner without stain, as we prayed to the Lord of all creation to grant our request to help us build a nation where no man would be oppressed, and so with peace and unity, Nigeria would be blessed.  Nigeria is 60 today, and we have much to celebrate: our indomitable spirit, our endurance, fortitude and resilience - and our hard earned unity. We have an unquenching optimism for progress, and I know that my motherland has come a long way from Independence Day on 1st October 1960 and the vision of our founding fathers till today. Reflecting on our nascent years I can declare that Nigeria was indeed blessed, albeit simply, with abundant natural resources to grow a healthy population and prosperous future for all. At the same time, agitation for equitable management of our abundant natural resources, and the resulting humanitarian crisis directed our first experiences of multilateralism. International donor agencies arrived to assist the suffering and displaced victims of our civil war, as the nation strove to heal its wounds. The multilateral agencies remain with us today, implementing key services towards the sustainable development goals, working alongside national and frontline organisations.  In those early formative years, lacking encounters with the basic day-to-day development challenges that shape creative public policy, our youthful nation paid little intentional and deliberate attention to the status of women and girls. We were so busy building our national unity, which at times was imperiled, that it didn’t occur to us to be intentional in our support for young women and girls to rise, even though culturally we have always revered and respected matriarchs and motherhood. This dichotomy has contributed to shaping some of the most dire realities of not meeting the needs of our women and girls that we as a nation face and experience today, where despite 50% of the electorate being women, the male gender occupies a disproportionate amount of cross-sectoral leadership positions.

This was why, as the First Lady of Kwara State in 2003 to 2011, I had deliberately and intentionally made it a point of principle to lend my voice and effort in mobilising women's groups and cooperatives to advocate strongly for the retention of the girl child in education and the domestication of Child Rights legislation through the Kwara State Child Rights Law of 2007, the Kwara State Safe Maternity Services Law of 2010, and the establishment of a framework to deliver universal health coverage through the Kwara State Community Health Insurance Scheme. The results went deeper than benefits to education, health and societal wellbeing that earned Kwara State the UNICEF accolade of being "fit for a child" in 2010, the first of Nigeria's 19 northern states to reach this ambitious standard - as by 2011, Kwara State had recorded over 35% of women in elective and appointive positions at federal and state levels, including several Senior Ministers of the Federal Republic of Nigeria, namely Amina Ndalolo, Halima Tayo Alao, Olufunke Adedoyin, and an ambassador, Nimota Akanbi.

Our present national reality is that Nigeria is the world capital for under-5 mortality and is among the top five countries with the highest maternal mortality rate. Though saving the lives of women and new babies will always evoke heartstring-pulling imagery, this is not merely a matter of compassion: this is a daily imperative and basic need for any country interested in sustainably developing. The safe transfer of life: from mother to child, and ensuring the health and wellbeing of both are preserved, is as key to socioeconomic development and economic growth as ensuring that families can access their rights and choice of reproductive intervals and size. A high level of maternal death means we have a lost population of women in the reproductive age: a youth and gender demographic that has been proven to be constructive for sustainable development. It also means we have a higher number of orphaned children and children without the benefit of the full family structure, a setup we know to be conducive to healthy lives. A high maternal death rate impacts women’s ability to participate in the labour force, which in turn decreases their ability to contribute to the economy. And, it consumes and hamstrings our budgets, and disables our ability to diversify our resources to other sectors for developmental purposes. 

The problems we face as a nation are a manifestation of the way in which we built our country, but today, at 60, and surely matured, we have an opportunity to catalyse an inclusive and cohesive course correction. We are centred on reiterating the national call to arise and serve our fatherland with love, strength and faith. We must reiterate that the labour of our heroes’ past shall never be in vain, and to serve our peoples with heart and might: one nation bound in freedom, peace and unity - to reach every last mile.

Right now, Nigeria’s Covid-19 deaths are comparatively low, and our nation’s endurance is high and strong; to me, possibly the product of a fortuitous resilience shaped by our long epidemiological history. However it is clear that the race to combat, contain and control Covid-19 is a marathon and not a sprint. According to The Economist’s Covid Collective Report, states like Nigeria are at risk of being “disproportionately affected because they have the least resources and infrastructure to grapple with the pandemic’s dire health and economic repercussions.” While richer countries are able to do more testing and prepare economic safeguards and recovery, Nigeria has recorded fewer tests per thousand people and has fewer resources to plan recovery.  Examples of collaboration among scientists, however, show that models for better cooperation are possible, and indeed a timely focus on home-grown research and development from Nigeria may yet have much to teach the world. Stronger frameworks and mechanisms for international cooperation are required to mitigate the adverse effects on lives and livelihoods globally, and in fragile settings in particular. The fact that 172 countries globally are engaged in discussions to participate in COVAX – a Covid-19 vaccine global access facility – demonstrates just how powerful global cooperation can be in finding collective solutions to collective problems. On our 60th celebration of independence, we reaffirm our patriotic call to direct our noble cause: that our leaders are guided right, our youth are helped to know the truth, grow in love and honesty, living just and true, attain great and lofty heights, to build a nation where peace and justice shall reign, a pledge to the progress of our nation. But we cannot deny that Covid-19 has laid bare fissures in the multilateral system with far-reaching implications. From climate change to economic recessions, geopolitical tensions to AI disruption, truly global challenges are only going to become more frequent in our increasingly-interdependent world. Every country is only as strong as the weakest link in the chain thus we know that the gaps in domestic and international safety nets are not just a threat to the world’s vulnerable populations but also to the functioning of the global economy and society as a whole.  As we celebrate the transformative power of patriotism, we must remember that no nation thrives entirely alone, and should work towards reviving multilateralism’s promise to ‘leave no one behind’ with particular focus on the effect of the pandemic on our most vulnerable women and girls. With the pandemic upending the world’s structural norms, Nigeria has an opportunity to come out of this dark time with a new energy based on the evidence of what works—and what does not work— to achieve our goals sustainably and for all. To meet the challenges of the 21st century, each and every one of us as individuals, along with our national governments, multilateral actors and humanitarian leaders must heed Covid-19’s wake-up call and unite to give multilateralism the “teeth” it needs to reform, replenish and strengthen national and global resilience both now and when the next crisis emerges, to ensure that our beloved nation Nigeria, and our people will survive, transform and thrive.

FROM September 26th, 2020

The biggest misconception about contraception in Nigeria is that contraceptives encourage promiscuity. The fact is, the education and economic empowerment of women directly correlates to their ability to plan, manage and thrive throughout their experience in the reproductive process.

So today on World Contraception Day 2020, I am leading the Wellbeing Foundation Africa in joining the WHO Department of Sexual and Reproductive Health and Research (including the United Nations Development Programme, the United Nations Family Planning association, UNICEF, the World Health Organisation and the World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) along with organizations and individuals worldwide in celebrating this important event.

Contraceptive information and services are fundamental to the health and human rights for everyone. Access to safe, quality, affordable contraceptive information and services, together with the provision of fertility care, allows people to decide whether and when to have children, and also the number of children they would like. Ensuring access to preferred contraceptive methods for women and couples is essential to securing their well-being and autonomy, while supporting the health and development of communities.
My decades of work to improve maternal health contributes to the rise of women because in Nigeria, first and foremost there is a critical need for mothers to plan their families, and survive childbirth in order to allow them to thrive. That is the ethos that drives my work as UNFPA Nigeria's Family Planning Champion, as a co-author of the Lancet Maternal Health Series on stillbirth, as a commitment maker to FP2020 Movement and the International Conference on Population and Development ICPD25, and as a lifelong advocate for women's rights to contraceptives and family planning.

In November 2016, the 4th Nigeria Family Planning Conference in Abuja hosted the Africa regional launch of The Lancet Maternal Health Series. National and international health leaders joined me and my Wellbeing Foundation Africa for this important gathering, including the Honourable Minister of Health Isaac Folorunso Adewole, Professor Oona Campbell, author of the 2016 Lancet Maternal Health Series and Professor Oying Rimon, The Bill and Melinda Gates Foundation, The Challenge Initiative, the Bloomberg School of Public Health,  DFID UK, USAID, Plan International, Evidence For Action, The White Ribbon Alliance and NURHI, the National Council for Women’s societies NCWS, and YWCA, among many national stakeholders.

With insights shaped by co-authoring the previous 2015 Lancet Maternal Health Series: Stillbirths: Economic And Psychosocial Consequences – and having attended the initial launch of the 2016 Series report at the global stage to coincide with the 71st UN General Assembly in that September, I observed that The Lancet Maternal Health Series covers the epidemiology of maternal health, the current landscape of maternal health care and services in both high- and low-income countries, and laid out future challenges and strategies to improve maternal wellbeing.

Addressing stakeholders alongside fellow panelists Professor Oona Campbell who launched the Series, Professor Adinma, Dr Kole Shettima, Dr Tunde Segun and Dr Allisyn Moran with the discussion entitled: “What is family planning doing for maternal health in Nigeria,” – I welcomed the Nigeria launch of the 2016 series, which provided all stakeholders and policy-makers the evidence with which to guide concrete actions to improve maternal newborn child and adolescent health services.

The launch of the 2016 report coincided with the revised WHO guidelines which recommend that pregnant women in low and middle income regions receive eight antenatal visits, and increased recommendation from the four antenatal visits previously indicated within the WHO’s focused Antenatal Care policy. It vindicated and validated the Wellbeing Foundation Africa’s MamaCare Antenatal And Postnatal Skills And Drills Curriculum model for midwives and mothers, respectively.  It demonstrated that the provision of a midwifery-led continuum of care and counsel, along with universal access to high quality affordable health services through community health insurance, improved training in emergency obstetric and newborn care, underpinned by integrating its robust patient-custody health records with digital facility health records and civil registrations data skill-sets are, together, crucial to improving survival and wellbeing.
As Nigeria’s first civil society community midwives health visitor program, the Wellbeing Foundation Africa’s MamaCare360 Antenatal and Postnatal Education Classes incorporate a postnatal session where breastfeeding techniques are delivered to mothers along with informed family planning advice. We affirm that access to family planning information and contraception is a fundamental human right, empower women to decide when and where to have a child, and how many children they wish to bear according to their circumstances, and recognising those rights, we recommend that mothers space their childbirth by 1000 days to better sustain the health and socio-economic wellbeing of mother, child and family.

In 2016, Nigeria had cause to celebrate the then-recorded 40% improved survival rates delivered over four years through Nigeria’s Midwives Service Scheme, despite government challenges in sustaining state and local government traction on these gains – which are sorely threatened today. That's because Nigeria has once again, in 2020, overtaken India as the worlds capital of multi-dimensional poverty, malnutrition, and under-5 mortality.

Prior to the interrupted access to routine family planning services caused by the coronavirus pandemic, most low- and middle-income countries were on course to experience substantial economic growth, which will increase their fiscal space for health investments in maternal and newborn health. However, with the expected surge in 'lockdown pregnancies' we must ready ourselves to harmonise and standardise the wide variations within quality of care, between two broad scenarios which reflect the landscape of poor maternal health care – the absence of timely access to care (defined as ‘too little, too late’) and over-medicalisation of normal antenatal, intrapartum, and postnatal care (defined as ‘too much, too soon’) - and the submerged social determinant factors of economic distress, and co-related domestic and gender-based violence.

Yet we know the steps to take to recapture early successes:
  • The National Task-shifting Policy: When community health workers were allowed to administer injectable contraceptives, the uptake of family planning in hard-to-reach areas went up dramatically. That success was irrefutably demonstrated in Nigeria.
  • It will be hugely beneficial to improve clarity on Nigeria’s currently confusing ‘dual-qualification nurse-midwife’ overlap, to provide clear distinctions between the midwifery qualification, and the general nursing qualification, applying the learning from the WHO Midwives Voices Midwives Realities Report, which documents the voices and realities of 2,470 midwifery personnel in 93 countries and describes, from their perspective, the barriers they experience to providing quality, respectful care for women, newborns and their families.
I urge our Federal Government and policy makers to consider:
  • Integrating the International Confederation of Midwives’ Midwifery Services Framework into Nigeria’s public health policy as the best practice model to strengthen midwifery services to deliver the full complement of maternal and newborn care, including family planning.
  • To honor their FP2020 commitments to improving family planning funding and services
  • To partner with donors and other non-governmental organizations to increase financing for family planning at all levels
  • To strengthen primary health care facilities to provide family planning counseling and services for increased access and improved coverage
  • To partner with non- governmental agencies and development partners to build the capacities of healthcare providers across all cadres to encourage task shifting/sharing to overcome human resource constraints
  • To strengthen country’s forecasting capacities and supply of family planning capacities
  • To adopt innovative approaches such as community-based family planning services, involvement of men, traditional and religious leaders as family planning champions to break religious-cultural barriers
  • To continuously create awareness on family planning for women and families to make informed decisions on birth spacing.
  • To scale up deployment of patient custody health records and facility and health-worker driven digital records databases to provide real-time transparent and accountable community audit mechanisms in measuring public health services delivery

Poverty, inequality, and geographical barriers all clearly play out in maternal health where both our challenges and opportunities abound.

We should, therefore, guarantee that every woman, everywhere has access to quality care. An essential part of advancing maternal health in Nigeria is accelerating, reinforcing and replenishing the progress of family planning education and services to all women, thus preventing unwanted pregnancy. It is true that women, families and communities need births to grow, yet it is unethical and simply unacceptable to encourage women to give birth in places with low facility capability, with unskilled providers, or where the content of care is not evidence-based. This failing should be remedied as a matter of priority.

To achieve the 2030 SDG global target of a maternal mortality ratio of less than 70 per 100,000 live births, we must prioritise quality maternal health services that respond to local needs; promote equity through universal coverage of quality maternal health services; improve the health workforce and facility capability; guarantee sustainable financing for maternal and perinatal health; and generate better evidence, advocacy, and accountability for progress.
The Wellbeing Foundation Africa’s Mamacare+Nutrition program which sub-implements the Nutrition International and UNFPA NLift Strategy though the Wellbeing Foundation Africa MamaCare Community Midwifery Program, improves maternal education, family planning and nutrition through iron and folic acid supplementation, supported by Global Affairs Canada, currently reaching 11,000 women at 60 Health Facilities and their surrounding households and Ward Development Committees in the Federal Capital Territory, Abuja.

FROM September 18th, 2020

The numbers are stark:

Women make up 70% of the global health workforce, but only 25% of global health leadership. That is primarily because midwives and nurses make up nearly 50% of the entire global health workforce, and midwives and nurses are over 90% women. Yet only 13% of CEOs in the global healthcare workforce are women. It is said that unlike other sectors, healthcare does not have a “woman problem,” rather, it has a “women in leadership” problem.  At the same time, there is a global shortage of health workers, in particular nurses and midwives, who represent more than 50% of the current shortage in health workers. And as Africa’s most populous country, Nigeria has one of the largest stocks of human resources to employ in healthcare, but it does not have enough people—women or men—working in the healthcare sector to support its population. At 1.95 per 1,000 people, Nigeria’s density of nurses, midwives and doctors is too low to deliver essential health services, which ultimately contributes to the abysmal state of its healthcare system. With the impact of coronavirus bringing global health systems to a halt, the prolonged lack of investment and systemic issues in Nigeria have compounded its vulnerabilities. This scenario makes the African continent susceptible to becoming the new epicentre of the disease.

To increase the number of health workers in Nigeria and improve on the number of women in positions of leadership in healthcare, we must build a progressive pipeline of confident girls, and support systems to remunerate healthcare workers properly, and build resilient healthcare systems in Nigeria. 

One way I’m working on supporting confident girls is through my organisation Wellbeing for Women Africa, which amplifies the voices of young African girls, by paying a global network of Youth Partners (currently we have 63 YPs from 18 countries) microgrants to write about their perspectives on the most pressing social issues of our time. For instance one YP recently released a study called Wa Wimbi, which demonstrated evidence that regardless of the sector, women continue to face discrimination and they are unable to progress due to gender barriers. The organisation aims to give young women a platform and in that way, a seat at the decision making table to ultimately allow them control over their own future. Because we know that girls’ learned lack of confidence is a barrier to their success later in life, ensuring that girls understand that their voice is important, their viewpoints are valid and that their perspective is not just interesting but worthy of remuneration, is one small way in which we can build a pipeline of women leaders. At the same time, there is an endless need for leaders in the public and private sectors to come together to figure out solutions for better recognition, regulation, respect and remuneration for health care workers in Nigeria in the interest of building that pipeline of healthcare workers in the country. My advocacy on this issue goes from strength to strength as Inaugural Goodwill Ambassador for the International Confederation of Midwives, to my membership of the Concordia Leadership Council, and it’s not an issue that is easily solvable or that can be explained with pithy phrases. It’s going to take international collaboration and years of governmental support to create a resilient system that can hold up over generations. One successful approach to increasing the number of midwives in our country was the Midwifery Service Scheme, established with the help of my Wellbeing Foundation Africa, which mobilizes unemployed and retired but able midwives and newly qualified graduates from Nigerian Schools of Midwifery to rural communities for one year of community service. As I recently noted, best practices identified under the scheme need to be reactivated and consolidated nationally. Within the Wellbeing Foundation Africa, we have seen, recorded and measured the value and sustained impact of placing a highly skilled midwifery workforce at the front, centre and heart of our communities-focused cradle-to-age programming, as coaches, educators, interlocutors, advocates and leaders, as the delivery centrifuge of our unique yet seemingly simple MamaCare Antenatal and Postnatal, SRHR, Nutrition, SGBV PSHE and WASH programs - and the results are crystal clear. Activating, actioning and tracking accurate information regularly through respectful and compassionate compassionate multi-directional conversations engender transformational social behavioural change and trusted learning, which together with deploying data for good, embeds key resilience into our community of best practice, improving the quality of care and lives. The fact remains that we must attract, employ, retain, remunerate and support healthcare workers by giving a powerful leadership path incentive: healthcare in Nigeria must be made a good career choice. A recent Institute of Economic Affairs report makes the case that Nigeria could do more to partner with high-income countries to secure investment, and do more to attract global investors and international financial institutions to finance their healthcare systems. For healthcare workers to want to stay in Nigeria, they must be supported by better working conditions, training, equipment, and insurance related to workplace risks, and remuneration.  Another way I’m working on this is by ensuring healthcare workers are properly trained. My Emergency Obstetric and Newborn Care Training Programme, or EmONC, is a ground-breaking partnership between the Wellbeing Foundation Africa, Johnson & Johnson and the Centre for Maternal and Newborn Health (CMNH) at Liverpool School of Tropical Medicine. The partnership focuses on EmONC training in healthcare facilities to improve health outcomes for mothers and their newborns, and it has seen 80% of all maternal deaths result from five complications which can be readily treated by qualified and trained health professionals. EmONC training is so successful because it takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome these obstetric emergencies, in an accelerated knowledge pathway from research bench to bedsides at the multi-tiered facilities most in need. The results again are clear, the state in which we have pioneered this training and achieved program saturation has the enviable status of the lowest preventable maternal and child deaths in the nation, informing my advocacy insistence of a push into the national health strategy, at scale. At the same time, the Institute of Economic Affairs’ report states that “African countries spend more on paying interests on external debts rather than on public healthcare.” It’s a fact that needs to change, and it can change only by way of leadership from the state and local governments, by ensuring our systems can properly fixate systems underpinned by rightly targeted budgetary planning and fiscal appropriations that invest public funds equitably back into the health of our own people to deliver accessible, affordable health care.

FROM September 15th, 2020

I am deeply concerned by the recent findings that Nigeria has overtaken India as the world capital for under-five deaths, according to the UNICEF report 'Levels and Trends in Child Mortality,’ particularly as we had previously seen significant improvements in Nigeria between 1990 and 2015. This distressing news comes just as we congregate virtually this year for the United Nations General Assembly. The report compiles data spanning three decades from 1990 to 2019, and it reveals that 49% of all under-five deaths in 2019 occurred in just five countries: Nigeria, India, Pakistan, the Democratic Republic of Congo and Ethiopia. It finds that Nigeria and India alone account for almost a third of the deaths, and what is evermore worrying is that it is clear that there is a strong potential of a continued mortality crisis in 2020 with the additional strain of the coronavirus pandemic.

I have always felt that if the nation is truly committed to the daily goal of ensuring that our women can give birth safely to babies that can survive and thrive from the cradle to age, we must strengthen and build resilience in our frontline health care services. 

Our primary health care services must be supported beyond bricks and mortar to encompass the full range of quality affordable health care provided by a well equipped, well skilled and adequately remunerated health workforce, who are motivated to deliver respectful maternity and child health care and advice. We must intensify our efforts to engender, enable, empower, replenish and reinforce the capacities of the most appropriate and qualified health professionals to stand with women and their families as a central core focus which will be validated, vindicated and reinforced throughout this Year And Decade of the Midwife and Nurse. We must build resilience within our healthcare system. In my opinion the significant 35% aggregated gains and improvement in maternal and child survival measured between 2010 and 2015 across Nigeria, which is now gravely threatened, was catalysed by the roll-out of the simple yet revolutionary Midwives Service Scheme (MSS), launched in 2009 by the National Primary Health Care Development Agency (NPHCDA), in 2009 during the administration of late President Umaru Yar Adua. It aimed to address the challenge of Nigeria's very poor record regarding maternal and child health outcomes. An estimated 53,000 women and 250,000 newborns were dying annually mostly as a result of preventable causes. The NPHCDA was tasked with establishing the MSS as a public sector initiative and a collaborative effort between the three tiers of government in Nigeria. A memorandum of understanding between the Federal, State and Local governments set out clearly defined shared roles and responsibilities, which were supported by the Wellbeing Foundation Africa and other strategic partners. The MOU was signed by all 36 states of Nigeria and was designed to mobilise newly qualified, unemployed and retired midwives for deployment to selected primary health care facilities in rural communities and facilitate an increase in the coverage of Skilled Birth Attendance (SBA) to reduce maternal, newborn and child mortality. The MSS Technical Working Group (TWG) met regularly to receive updates, review progress and advice in order to provide strategic direction, support and guidance for the implementation of the MSS. The secretariat of the MSS was responsible for day-to-day management, whilst state focal persons served as contact people for the midwives in the MSS. The MSS was based on a cluster model in which four selected primary healthcare facilities with the facility to provide Basic Essential Obstetric Care (BEOC) were clustered around a General Hospital with capacity to provide Comprehensive Emergency Obstetric Care (CEOC). Qualified professional midwives were deployed to each selected PHC, ensuring 24 hour provision of MNCH services and access to skilled attendance at all births to reduce maternal, newborn and child mortality and morbidity. The MSS pilot then covered 163 clusters, which had 652 PHCs and 163 general hospitals. The MSS strengthened the PHC system by distributing basic equipment (midwifery kits, BP apparatus etc, and a comprehensive civil registrations and vital statistics data capture system including partographs, to all facilities, in the form of the IMNCH Personal Health Records and Home-Based Records, developed by the Wellbeing Foundation Africa) to 652 facilities through the vaccine logistics system. The MSS was successful in establishing and reactivating ward development committees WDC's at all MSS PHCs to ensure community participation and ownership in its implementation. The outcomes were impressive and immediately impactful: 2,488 midwives were successful in applying to the MSS and were deployed to PHC facilities. The midwives from all over Nigeria were then given an orientation which I was pleased to host, as a member of the Critical Core Committee of the FMOH to upskill and familiarise them with the scheme. As of July 2010, 2,622 midwives had been deployed to PHC facilities in rural areas. MSS provided capacity building by the creation of a training framework, which was aimed at improving the skills and proficiency of midwives in provision of quality maternal and child health services. The midwives then underwent competency training through Principals of Schools of Midwifery. The MSS planned to implement information and communications technologies support to improve communication and articulated a monitoring and evaluation framework for the scheme.  Partners, including the Wellbeing Foundation Africa, committed to initiating and implementing a two-pronged approach to programme communication: it focused on political leaders and decision makers, as well as clients, through radio, TV, billboards, community outreach, and health centre branding to ignite social and behavioural change and demand creation for health-seeking and health providing orientation. The MSS faced (and still faces) five key challenges, namely: 1) implementation of the Memorandum of Understanding, 2) availability of qualified midwives, 3) retention of midwives, 4) capacity building of midwifes and 5) sustenance of linkages. There needs to be more support and commitment from officers in relevant government departments, which can be achieved by ensuring clarity on the objectives and aim of the MSS. Over the years, several initiatives and programmes had been introduced to reduce mortality among mothers and children in Nigeria. Despite these efforts, poor maternal and child health indices had continued to be one of the most serious development challenges facing the country. Significant progress was accomplished in the implementation of the MSS initiative however and the best practices identified under scheme need to be reactivated and consolidated nationally, with a view to overcome challenges. Despite the dire recent national indices, which were not entirely unexpected given the stoppage of the original MSS and its replacement with an eponymous but less focused model, I remain encouraged to redouble my institutional efforts for maternal and child survival. I am encouraged by the fact that Kwara and Lagos States, where my Wellbeing Foundation Africa has achieved and maintains significant programmatic scale, are now consistently recorded as having the two lowest preventable mortality rates in Nigeria respectively, while Kaduna State and the FCT Abuja where we also work have shown significant improvements. These gains highlight the importance of the WBFA's midwifery-led direct frontline action models which deliver our MamaCare Maternity Education, EmONC Healthworker Training, WASH for Wellbeing and Hygiene in Health Facilities, Child and Adolescent PSHE WASH In Schools, and Alive&Thrive Maternal Infant and Young Child Feeding and Nutrition programs.  In tandem, we support strong accountability frameworks that can hold governments to account on their health commitments to drive a policy continuum of health for all. Mindful of the fact that we have only ten years to accelerate actions towards our 2030 Sustainable Development Goals, the Wellbeing Foundation Africa is energised by the WHO and multi-lateral agencies’ commitments to pursuing stronger collaborations for better health. In addition, we commit to strengthening deliberate sexual and reproductive health and gender programming and women's leadership, with the simple premise that stronger collaborations contribute to better health. This Global Action Plan for healthy lives and wellbeing for all, will promote, engage, accelerate, align and account for purposeful, systematic, transparent and accountable primary health care. It will create sustainable financing for health, community and civil society engagement, improve determinants of health, invest in innovative programming in fragile and vulnerable settings and for disease outbreak responses as well as research and development, innovation and access, data and digital health.  In promoting better leadership at global, regional and country levels, stronger collaboration is the path, but better health is the destination. If the nation cares to ensure women can give birth safely to babies that survive from the cradle to age, we MUST strengthen frontline health care services, immunisations, nutrition and WASH - I hope that the community of best practice we have developed and implemented towards healthy lives and wellbeing for all, from birth to age may cascade its impact across my nation Nigeria, Africa, and the world.

FROM September 11th, 2020

This week, my Wellbeing Foundation Africa's partners at Amref Health Africa led an excellent session - "A Health Accountability Framework, Holding Governments Accountable for their Health Commitments” . I warmly welcomed the discussion of the importance of supporting strong accountability frameworks, such as the Right to Health Index, that can hold governments to account on their health commitments. The Right To Health Index is grounded in the recognition that health accountability needs to move away from using general statistics and focus instead on identifying specific indicators for use in human rights. In doing so, accountability frameworks can facilitate the realization of health as a human right and universal health coverage for all. Health as a human right has always been central to The Wellbeing Foundation Africa’s work, particularly the infusion of poverty alleviation, rights and gender-based programming into the WBFA's Alaafia Universal Health Coverage Scheme Fund in partnership with the PharmAccess Foundation and Hygeia Community Health Plan.   The Fund, supported the Kwara State Health Insurance Scheme established since 2007 by advocating for the 2012 and 2017 enabling state health insurance legislation, and by directly providing yearly capacitation fees for 5000 pregnant and newly delivered women, as well as adolescents, people living with HIV/AIDS, and elderly beneficiaries annually, within it's over 100,000 enrollees from 2015 onwards. Certainly, this availability of quality affordable care has contributed in no small measure to Kwara State maintaining its status as the state with the lowest maternal and under-5 mortality in Nigeria, at a time when the nation has been confronted with the unfortunate fact of having overtaken India as having the highest and worst preventable deaths of mothers and their young children globally - underscoring the importance of sustaining focused efforts across all 36 states of the federation to arrest this devastating trend of neglect.     https://www.youtube.com/watch?v=lVfErQTKH6Y&feature=youtu.be H.E. Senator Dr Abubakar Bukola Saraki, MBBS, CON, 13th President of the Senate and Chair, 8th Session National Assembly, Federal Republic of Nigeria, Former Kwara State Governor and Chair, Nigeria Governors Forum, at the Scale Up Ceremony of Kwara Community Health Insurance Scheme, Afon, Kwara State, 2009 I was also delighted to learn this week that the health insurance scheme has been recently re-launched with a target of 10,000 more mandatory enrollees. I heartily commend the PharmAccess Foundation and other partners for their focused tenacity in ensuring that the exemplary health insurance-driven universal health coverage model that all partners worked so hard to create and innovate, driven by the mutual vision of H.E Dr Abubakar Bukola Saraki  and the late acclaimed global health expert and medical research scientist Joep Lange to render affordable quality health care for all will continue to support and benefit many more people into the future. [caption id="attachment_1199" align="aligncenter" width="603"] Wellbeing Foundation Africa, Hygeia Community Health Plan, Pharmaccess Foundation, World Bank Nigeria, Federal Ministry of Health at Alaafia Universal Health Care Scheme Fund Conclusion Breakfast Meeting, Abuja, Nigeria, January 2017[/caption]

FROM September 2nd, 2020

Road safety in Nigeria is both a global health issue and a matter calling for focused national concern: road traffic accidents are the leading cause of death in adolescents in Nigeria. More broadly, there has been an upsurge in the proportion of traffic fatalities witnessed in a number of developing countries while developed nations are witnessing downward trends. 

That is why I welcome the United Nations General Assembly and member states in passing an historic resolution endorsing the “Stockholm Declaration”, aiming to improve and save lives on the world's roads, today. Nigeria has the second largest road network in Africa, and our latest figures show that Nigeria is among the top 50 countries with the highest road traffic deaths. According to the NRSS, population-road ratio was estimated to be 860 persons per kilometre roadway while vehicular density stood at about 39 vehicles per kilometre roadway. Nigeria recorded 337,301 road traffic crashes from 1990 to 2012, out of which 28.6% were fatal, 44.7% were serious, and 26.7% were minor. The overwhelming majority of road traffic deaths and serious injuries are preventable and, despite some improvements, they remain a major public health and development problem that has broad social and economic consequences which, if unaddressed, may affect progress towards the achievement of the Sustainable Development Goals (SDGs).  While each country has primary responsibility for its own economic and social development, the role of national policies, priorities and development strategies cannot be overemphasized in the context of reaching the SDGs. At the same time, international public finance plays an important role in complementing the efforts of countries to mobilize public resources, especially in the poorest and most vulnerable countries with limited domestic resources. I acknowledge the work of the UN system, in particular the leadership of the World Health Organization, in close cooperation with the UN regional commissions, in establishing, implementing and monitoring various aspects of the Global Plan for the Decade of Action for Road Safety 2011–2020. I recognize the commitment of the United Nations Human Settlements Programme (UN-Habitat), the United Nations Environment Programme, the United Nations Children’s Fund and the International Labour Organization, among other entities, to supporting those efforts as well as that of the World Bank and regional development banks to implement road safety projects and programmes, in particular in developing countrie.  I hope that this historic resolution will encourage all Member States to promote multi-stakeholder partnerships. I point to my Wellbeing Foundation Africa’s anatomical simulation training techniques that aim to improve health workers’ skills to address the safety of vulnerable road users, the delivery of emergency care and first aid to victims of road traffic accidents. Notably, this must happen more aggressively in developing and least developed countries, and we must provide road traffic crash victims and their families with universal access to health care in the pre-hospital, hospital, post-hospital and rehabilitation and reintegration phases. In addition, I will do my part to raise funds to bring in the right equipment for road accident trauma training. I must particularly commend the leading role of Oman and the Russian Federation in drawing the attention of the international community to the global road safety crisis. And, I must congratulate the Member States that have taken a leadership role by adopting comprehensive legislation on key risk factors, including the non-use of seat belts, child restraints and helmets, the drinking of alcohol and driving, and speeding, and drawing attention to other risk factors, such as low visibility, medical conditions and medicines that affect safe driving, fatigue and the use of narcotic drugs and psychotropic and psychoactive substances, mobile phones and other electronic and texting devices. With the lessons learned from the Decade of Action for Road Safety 2011–2020, the Global Development Community recognises the need to promote an integrated approach to road safety such as a safe system approach and Vision Zero. We must pursue long-term and sustainable safety solutions, and strengthen national intersectoral collaboration, including engaging non-governmental organizations, civil society and academia, as well as businesses and industry, which contribute to and influence the social and economic development of countries. I hope that state and non-state actors and policy makers will commit to prevent road traffic injuries, while I appreciate the WHO and its Director-General, Dr Tedros Ghebreyesus for its role in implementing the mandate conferred upon it by the General Assembly to act, in close cooperation with the UN regional commissions, as a coordinator on road safety issues within the UN system. Providing basic conditions and services to address road safety is primarily a responsibility of governments. This is especially in view of the decisive role that legislative bodies can play in the adoption of comprehensive and effective road safety policies and laws and their implementation. However I recognize nonetheless that there is a shared responsibility to move towards a world free from road traffic fatalities and serious injuries and that addressing road safety demands multi-stakeholder collaboration among the public and private sectors, academia, professional organizations, non-governmental organizations and the media. That is why I acknowledge that increasing road safety activities and advocating increased political commitment to road safety, will require working towards setting regional and national road traffic casualty reduction targets, elaborating global road safety-related legal instruments, including international conventions and agreements, technical standards, resolutions and good practice recommendations. It also requires domesticating and servicing 59 global and regional legal instruments that provide a commonly accepted legal and technical framework for the development of international road, rail, inland water and combined transport, to strengthen Nigeria's national road safety management capacity. As we approach the end of this Decade of Action for Road Safety, and start on the relevant road safety target dates set out in the 2030 Agenda, Nigeria must deepen national engagement with the new 2021-2030 time frame for a reduction in road traffic deaths and injuries. To push forward in the Second Decade of Action for Road Safety, with a goal of reducing road traffic deaths and injuries by at least 50% from 2021 to 2030, I support the call upon Member States and stakeholders to continue action through 2030 on all the road safety-related targets of the SDGs, including target 3.6, in line with the pledge of the 2019 High-Level Political Forum on Sustainable Development convened under the auspices of the General Assembly. We must especially take into account the remaining decade of action to deliver the SDGs by 2030 in their entirety.

FROM August 25th, 2020

Today is the day we have set our sights on for decades. Because of years of work by health workers on the ground, with the support and collaboration of international nonprofits, national and local governments, and with the weight of the world’s attention, we are able to celebrate this momentous achievement: Africa is wild polio-free.

I am overjoyed that today, thanks to 25 years of coordination and commitment by the World Health Organization (WHO) and the World Health Organization Regional Office for Africa (WHO-AFRO), wild poliovirus no longer threatens our children and future generations of children across the African continent. The achievement is all the more remarkable as the result of an instrumental campaign to vaccinate children in Northern Nigeria, a region that is choked by terrorist extremist rule. As of today, Africa is the fifth of six global regions to be officially declared wild poliovirus-free; with cases of the virus now found only in the eastern Mediterranean region. This milestone has been achieved through successfully scaling up and sustaining the delivery of vaccines to children in the hardest-to-reach places throughout Africa.   My Wellbeing Foundation Africa has proudly supported the communities we work with to detect, interrupt, and eliminate the wild poliovirus, alongside our global and national partners. Our programmes give mothers access to information on the safety and importance of vaccines, and our Personal Health Records are now a necessity in order to empower them to make immunisation choices in the best interests of their children. Now, thanks to the tireless efforts of so many working to ensure polio vaccines reach the most remote corners of the world, more than 18 million children who would have faced polio paralysis in the past are walking freely towards healthy futures. As the COVID-19 pandemic continues to disrupt health services, damage health systems and burden health workers, it is imperative that we come together globally, again, to address the public health challenges of the future. We must strengthen routine immunization programs in Nigeria, specifically to achieve full eradication of all forms of polio, including circulating vaccine-derived poliovirus, which remains prevalent in areas with weak or partial immunization coverage. To build on this enormous success, we must sustain our commitment to mass immunization campaigns, and we must do more to stop dangerous misinformation from spreading. Today marks a truly momentous milestone. My Wellbeing Foundation Africa offers our deepest congratulations and respect to the heroic health workers, community leaders, and volunteers who have contributed to this tremendous success. Congratulations, Africa!

FROM August 11th, 2020

The lived experience of Riskiat, the blue-eyed woman from Kwara state, underscores the need for economic empowerment to also tackle unconscious bias and gender discrimination.

  Riskiat Abdulazeez and her daughters grabbed headlines and pulled heartstrings in Kwara state last week when she spoke out with a distressing story about being abandoned by her husband and rejected by his family. The 30-year-old mother of two was left alone to afford food and education for her children, all because of a scepticism surrounding her distinctive pale blue eyes.  When I studied Riskiat’s story, what struck me was not just the unique (and beautiful) colour of the eyes: it was the fact that her life story is that of a typical woman in Nigeria—a story that so many of the United Nations’ goals and resolutions aims to target, support and empower.  She was a girl child who had every hope, but encountered every barrier.  [caption id="attachment_1183" align="alignnone" width="640"]Riskiat and her children Riskiat and her children accepting the donation from the Wellbeing Foundation Africa[/caption] As a child, Riskiat went to primary and secondary school, but didn’t sit her final examinations because her parents could not pay the fees, as she explained to PUNCHNG. Instead, her parents enrolled Riskiat in an apprenticeship, and following the apprenticeship, she worked in a shop where she met her husband, Abdulwasiu, in her early 20s.  After courting for a year, Riskiat and Abdulwasiu married, and Riskiat quickly gave birth to three children: five-year-old Kaosara and one set of twins, two-year-olds Hasanat Kehinde and Taiwo. The daughters, Kaosara and Hasanat Kehinde, inherited Riskiat’s distinct eye colour, while Taiwo, the son, had traditional brown eyes. The family lived together in Abdulwasiu’s family home, and Abdulwasiu, a vulcaniser, struggled to support the children’s diet and education, particularly as the COVID-19 pandemic brought Nigeria to a halt. It is clear through Riskiat’s interview that Abdulwasiu’s family was distrustful of Riskiat already—but the trigger point that led to the family breakdown happened when the male twin, Taiwo, fell ill earlier this year. As Riskiat illustrates in PUNCHNG, the family could not financially support his care, and ultimately, Taiwo died from his illness. The grief and devastation eroded the family’s cohesion even further: distraught because of the loss of his son, poverty-stricken and pressured by his family’s scepticism about the fact that Riskiat and the blue-eyed daughters had survived, Abdulwasiu instructed Riskiat to move out of his parents’ home. “He told me that his parents said they could not live with children with blue eyes. My husband also said his parents told him to marry a woman that would produce children with normal eyes,” she told PUNCHNG. We have always known that unplanned point-of-care medical expenses can throw families into poverty, but Risikat’s story shows us the devastating effect that unavailability of medical coverage can wreak. It impacts lives negatively far beyond the original community coverage aims of health for all. What Riskiat has yet to experience is self-sustaining autonomy via her own economic empowerment. As a child she was barred from further education because her family could not afford the fees. As a young adult, she attempted to make a living for herself, but instead married young and then struggled to feed, educate and protect her family because she relied on her husband, who could not support them. At 30, Riskiat has fire in her belly and light in her blue eyes: she insists that she does not want her husband back, and is steadfast in her interest in finding the best path forward for her children.  “God who created us has plans for every individual. I don’t have any specific thing (planned) for her and her sister. I only wish that they would become great in future” she said to PUNCHNG.   [video width="848" height="480" mp4="https://toyinsaraki.org/wp-content/uploads/2020/08/WhatsApp-Video-2020-08-08-at-2.25.56-PM.mp4"][/video]   Riskiat’s inability to control and plan her own life is the story of many women just like her, particularly in Nigeria. Country-wide, at age 20, less than 4% of men are married, compared to about 50% of women in rural areas. In some areas, around 40% of girls are married and 11% give birth all before age 15, which robs them of their educational attainment, career mobility and earning power, and makes them vulnerable to dangerous pregnancy complications like fistula. Moreover, we know that when we invest in women and girls, they invest in everyone else around them. That’s why I was not surprised to read that Risikat took a decision to sell her small patent medicines shop to raise the resources to feed her family during trying times. Women typically invest a higher proportion of their earnings in their families and communities than men. Women’s economic participation and ownership of their own finances helps overcome poverty and improves children’s nutrition, health, and school attendance.  Reading about how Risikat lost her twin son Taiwo, due to not being able to afford the necessary medical care in Kwara State in 2020, shocked my core beliefs, advocacy and actions regarding universal health coverage. From 2007 to 2016, my Wellbeing Foundation Africa’s Alaafia Universal Health Access Fund had supported the Kwara State Government in its partnership with Hygeia and the Pharmaccess Foundation, in launching the Kwara Community Health Insurance Scheme (CHIS), providing a comprehensive package of healthcare to all indigenes, and mitigating the economic devastation of unplanned point of care expenses with a record-breaking and prize winning low capacitation fee recognised as recently as 2012, 2014 and 2015. The Kwara State CHIS was renamed KwaraCares in late 2018, and shockingly, was inexplicably not accessed or not available to Risikat and her children in 2020 despite its strongly vociferous media presence. So when I intervened in Riskiat’s situation with a token donation for her children’s education, it is not just because of compassion for a woman and children with striking eyes. It is because a small investment in Riskiat—allowing her basic economic empowerment, and the ability to make her own autonomous choices for her life and that of her children independently—has the potential to stop a cycle of disempowerment and negative dependency that Riskiat and so many others experience. Alongside making the donation, I also immediately requested that the eminent Professors of Medicine at the long renowned University of Ilorin Medical Centre of Excellence and Teaching Hospital respectfully offer the family full medical screening, as the striking beauty of their blue eyes aside, it is not unusual for cases of ocular albinism to be associated with rare genetic conditions. I made this donation and medical referral as I continue to advocate that public health and education policies must deliberately, intentionally, and accountably replenish resources. They must reinforce learning and knowledge and embrace gender-data statistical values in managing pro-poor innovations and universal health coverage, to put people first, particularly women, newborns and girls, and leave no one behind, particularly in Kwara State where the Wellbeing Foundation, stakeholders and non-governmental organisations continue to work so hard and long to deliver the lowest under-5 mortality in the land.  

FROM July 22nd, 2020

I am overjoyed to receive a photo and update from a Wellbeing Africa Foundation mum today, and I must share the story.

In 2017, Mrs O was pregnant with triplets, and had been a student of my #Mamacare360 program. She needed, but couldn't afford a Caesarean, and the hospital just kept her waiting. The hospital was ready to abandon them. I have always advocated for socio-economic birth preparedness within universal health coverage, but birth waits for no-one, so I dashed there to help immediately. That's because a sound anti-poverty strategy should not only aim to increase incomes, but also provide the poor with a variety of assets — personal, social, political and environmental to help them overcome the myriad of challenging circumstances. ⁣ Sometimes being there for the right person, with the right help, at the right place, can change a life (or in this case, three more lives) way beyond the original aim of poverty alleviation. ⁣ Here is a photo of the absolutely beautiful triplets today: they have grown so big and strong, and it has made a sunny day today even brighter. [caption id="attachment_1178" align="alignnone" width="300"]Triplets The triplets, 2020[/caption]

FROM July 21st, 2020

A few weeks ago, I read an absolutely harrowing story of abuse in Akwuke, near Enugu City, Nigeria, and it has been on my mind ever since. I am consumed by the fact that its graphic nature and intimate impact were entirely preventable, if only the right systems were in place.

Early in June, a wife and mother of two young boys—we will call her Mrs. K—asked her husband for money to prepare food for the family. He had a history of violence, and he lashed out about the inquiry: when she proceeded to make pap for her 3-month-old baby, he doused her breasts in boiling water. She reacted in the throes of excruciating pain, and also unable to breastfeed her baby. The Women’s Aid Collective (WACOL) posted the story on Twitter, including graphic photos that I am choosing not to continue to publicise. WACOL has confirmed that the husband is now in police custody, but the psychological, emotional and physical damage to Mrs. K and her children has been done, and it is on us to use this case as a calling to rethink how we are handling the scourge of domestic violence in Nigeria.

The story is the horrific climax of a pattern that we know to be true when it comes to domestic violence: notable triggering factors for the husband’s actions in this case are concerns about money, food, and the fact that Mrs. K was exercising her personal autonomy—through breastfeeding the baby. We know firstly that domestic violence is rising due to pressures about money amidst the pandemic; secondly, research also shows that male partners who are inclined to violence increase aggression during pregnancy and after birth, and thirdly, we know that jealousy (in this case, about feeding the baby) can be a trigger for men inclined to violence.

While the global community is aware of these factors, limited access to reporting pathways means local organisations weren’t able to shield Mrs. K before the abuse was so great that it required extreme intervention. Her case makes evident that the reporting of incidents of intimate nature, such as sexual assault and domestic violence, necessitates the transfer of Sexual Assault Referral Centres (SARC) from police stations to hospitals.

The Nigerian police force is culturally hyper-masculine and male-dominated, and Nigerians are 20 times more likely to be killed by the police than by terrorists. It is obvious that an aggressive and masculine environment in a conservative cultural setting is not a safe space for vulnerable women to share intimate stories about private parts of their body. In fact, a police station in Nigeria could be the worst place I could think of for a woman to go to seek relief. That’s why I’ve begun reaching out to call for a timely policy shift, nationally, to shift SARCs to hospitals: the hospitals would assume locus as expert witnesses, and bear the formal responsibility for reporting and advising the police on sexual and domestic violence cases. In turn, the idea is that injured women, or women in danger would feel more comfortable seeking treatment about intimate issues than in a police station. They would be treated for their ailments, and hospital staff would assume the responsibility for translating actionable items to the police. Like any crime, the prospect of swift justice, would also serve as a deterrent, and thus a very timely tool in the strategy to effect preventive social behavioural change.

This call to action is about ensuring we have the right systems in place to safeguard and ultimately empower vulnerable women with the public resources we have available. It is said that sexual and gender based violence is within the lived experience of almost half of our women and girls; equipping health personnel with specialist SGBV SARC and mental health training is both prerequisite, and an imperative.

At the Wellbeing Foundation Africa, we have long offered women attending our health facility based Mamacare antenatal and postnatal sessions a safe space, and a curriculum to discuss concerns, and if needed, report their worries. Nigeria’s updated National Gender Policy should take a whole-family, socio-economic and mental health approach to tackling the scourge of domestic violence; and one way we can start is by ensuring the safe haven of refuge, of a kind of solace: a comfortable environment for vulnerable women to give forensic evidence, find relief, and heal. We must do it for Mrs. K.

FROM July 14th, 2020

I thoroughly enjoyed kick-starting the new week by participating at the UN High-level Political Forum side event entitled, "From Page to Action: Accountability for the Furthest Left behind in COVID-19 & Beyond.” The conversation was strong, timely and direct, as well as being a fantastic way to launch the 2020 Report of the UN Secretary-General’s Independent Accountability Panel for Every Woman Every Child. Co-hosted by the Governments of Japan, South Africa, and Georgia and co-organized by the Every Woman Every Child Secretariat, the Independent Accountability Panel (IAP), International Health Partnership for UHC 2030 (UHC2030), and the Partnership for Maternal, Newborn & Child Health (PMNCH), I appreciated the opportunity of knowledge sharing to deepen the efforts and engagement of my organisations, the Wellbeing Foundation Africa, and Wellbeing For Women Youth Voices towards promoting institutional accountability at national, regional and global policy tiers. As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic in expectation of focused investments, we are once again reminded that the initiation, solution and fiscal appropriations to drive the delivery and accountability of truly accessible health for all must be embraced and fall within the remits of local and national parliaments. Today, and every day, I particularly commend the WHO Partnership for Maternal Newborn And Child Health PMNCH's ongoing strong collaboration with the International Parliamentary Union IPU, as signalled by the Inter-Parliamentary Union's historic first resolution towards Universal Health Coverage in 2019, substantiating global approaches to recordkeeping. I was particularly enthused by contributions from a number of high-level speakers and leading voices for the delivery of Universal Health Coverage, namely, H.E. Mr. Cyril Ramaphosa; President of South Africa; Chairperson of the African Union, Mr. Shinichi Kitaoka; President, Japan International Cooperation Agency JICA, Ms. Joy Phumaphi, Co-Chair, Independent Accountability Panel for Every Woman Every Child, Mr. Elhadj As Sy; Chair of the Board, Kofi Annan Foundation, Ms. Gabriela Cuevas Barron, President, Inter-Parliamentary Union, Dr. Khuất Thị Hải Oanh; Civil Society Engagement Mechanism, UHC2030, Dr. Natalia Kanem, Executive Director, UNFPA, H.E. Mr. Kaha Imnadze; Permanent Representative of Georgia to the UN, H.E. Ms. María Fernanda Espinosa Garcés; Member, UHC Movement Political Advisory Panel, UHC2030, Ms. Evalin Karijo; Project Director, Youth in Action, Amref Health Africa, Mr. Peter MacDougall, Assistant Deputy Minister of Global Issues and Development, Global Affairs Canada, Dr. Tedros Adhanom Ghebreyesus; Director-General, WHO; Chair, H6 Partnership, Rt. Hon. Helen Clark, Former Prime Minister, New Zealand; Board Chair, PMNCH, and of course, Ms. Gillian Tett; Chair of the Editorial Board & Editor-at-Large (US), The Financial Times (Moderator), alongside so many EWEC partners and frontline organisations. But as the COVID-19 pandemic’s grip on the world shows no immediate signs of loosening, organisations must therefore acclimatise effectively, by integrating the dual-mindset towards technology, in equipping their workforces and ensuring that the dissemination of information – particularly pertaining to health - remains both accurate and accessible. By making this part of an ongoing global transition a priority, we will see to it that society’s most vulnerable individuals are able to continue accessing the information and services which remain a key component in their livelihood. As Nigeria, seeks to mitigate the regrettable and inexcusable reputational damage that recent appalling breaches in cybersecurity have caused, we must also underscore the vital role that technologically supported security platforms play in enabling for remote operations and a continued key health services to be delivered when implemented effectively. Invoking cybersecurity measures have been and continue to constitute a key component in ensuring that accurate health information is circulated worldwide, particularly during this Covid-19 pandemic. We must therefore support all initiatives and efforts in the direction of this construct remaining a top global priority.

FROM July 6th, 2020

For many years, the welcomed priority, purpose and daily-sensitised goal for Women and Girls, Families and Communities - nationally and across our continent as a whole - has been to solidly create, inform, empower and manifest a true demonstration of equality, access and social responsibility regarding their health, their education and the equitable opportunities afforded to assure and improve basic wellbeing, from birth to age. Through the continued collaborative efforts of our nation’s healthcare professionals, researchers, thought-leaders, community volunteers and the service users themselves, Nigeria had long subscribed to the notion of investing in Universal Basic Education. However, the first time that citizens experienced the concrete benefit of an intentional basic or primary public health assistance was in 2018, when Nigeria’s 8th National Assembly appropriated the Basic Health Care Provision Fund – a pinnacle moment in the redemption of the 2001 Abuja Declaration towards achieving Universal Health Coverage. Today, that resounding national applause remains of strong resonance to the Joint Civil Society Organisations Primary Healthcare Revitalisation Support Group to the Eighth National Assembly, which I had chaired. With that being said, a real sense of recurring readiness and receptiveness to campaigns, cultural change and the communication surrounding health and wellbeing as a whole remains palpably evident, statistically proven and collectively celebrated by many – both nationally, and worldwide, and is categorised amongst what still remains a series of promising results acquired through WBFA’s advocacy and partnership efforts with policy-makers and parliamentarians worldwide. In addition, and perhaps more pertinently given the progression of the ongoing COVID-19 pandemic, my morale embodies the significance and importance of global partnership interventions such as that of the Global Financing Facility and the Global Citizen Fund. Their commitment to amplifying the importance of collective efforts in acquiring globally accessible health tools and resources during the pandemic, brings us all one step closer to the concept of continuity of services becoming a very possible reality. As, the Global Financing Facility announced its predictions last week, it conveyed a new set of commitments aimed at mitigating the disruption of services to a number of the countries and global communities most in need. GFF forecasts a possible 18% increase in child mortality, and a 9% increase in maternal mortality across Nigeria over the next year as a direct result of essential health services becoming fragmented during this COVID-19 pandemic. We had only recently learnt the surprising news that Nigeria's 9th National Assembly had predicted a reduction in the value of the primary healthcare and basic education budgets, which as unaddressed to date – reflect as cuts. However, as 30th June marked the International Day of Parliamentarianism, I was also caused to reflect upon the OECD’s interpretations of the role of parliaments during the COVID-19 crisis.  The COVID-19 pandemic is posing threats not only to human health and life, but also to people’s socio-economic well-being and countries’ economic growth. According to the OECD, the global economy is currently suffering its deepest recession since the Great Depression in the 1930s. One of the many visible issues of the current pandemic is the rampant unemployment and loss of income. As well as the increase in poverty, it could impede people from accessing basic services due to unaffordability and inaccessibility. It is estimated that 2.9-5.2 million people could lose their jobs in Indonesia as a result of this global health crisis. Clearly the pandemic is heightening inequality and inequity among citizens as well as within the countries themselves. Yet, presently, the role of parliament is more relevant today than it has been ever before. Parliaments can propose and adopt necessary laws to assist their respective governments in intercepting and tackling COVID-19 and its adverse impacts. Further, parliaments can oversee the expenditure of the public funds related to COVID-19. It is crucial to ensure that the funds are allocated appropriately, and that all individuals receive fair distribution of strategically proposed COVID-19 containment measures. In responding to the COVID-19 crisis, parliaments in Nigeria, and around the world have also established designated Task Forces for COVID-19, aiming to provide assistance and support in the form of medical equipment and personal protective equipment to hospitals and community health centres, in a globally observed and commended response. Every state has different capacities and resources to counter the challenges, whether it is providing and maintaining optimal and accessible healthcare, upholding a functioning and thriving society or managing the state of the global economic. Therefore, international co-operation is imperative, in order to ensure that states - especially within low- to middle-income countries, are able to thrive in this moment of crisis, and eliminate their obstacles in tackling COVID-19. Not surprisingly, three weeks ago, I had joined a high-level discussion on how the ongoing COVID-19 pandemic perpetuates the pressing need to implement Universal Health Care. In welcoming the Africa Leads UHC One By One 2030 Report, and in the new Unite For Action global commitments, I fully agreed that primary health care must cover the breadth of the journey from hospital to hut in communities, and improve the social determinants of all those living and working therein. We should not wait to improve the situation until, God forbid, the next crisis occurs. We have to ensure that our nations’ socio-economic development would not leave anyone behind, as envisaged by the 2030 Agenda. In that regard, every decision, law and regulation made must also be based on principles of equality, participation, non-discrimination, accountability and transparency. I have urged all African Leaders to reinforce and reconfigure their commitments to the 2001 Abuja Declarations in order to exceed the minimum pledged 15% of respective Consolidated Revenue Funds, if we are indeed to fulfil our mantra’s of Africa Rising – to match these global commitments with clear manifestation of a sense and purpose, of evidenced intention, to put our people first, justifying continued global partnerships and multi-lateral assistance. As we face the prospect of reinstating routine primary health and education services that were so destructively interrupted by the coronavirus pandemic, it is clear that Africa needs to factor in the replenishment and reinforcement of investments in both primary health care, and primary education. In doing so, they will build resilience to emerge from the pandemic in a stronger position than before. We must ensure that our weakest frontline services can deliver a healthier, better and stronger educated future for all. As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic, in expectation of focused investments we are reminded then, that the initiation, solution and budgetary injection must primarily derive from the pots that sit within local parliaments, while recalling that in fact, in 2019, the Inter-Parliamentary Union did actively play its part in passing its historic first resolution towards universal health coverage, substantiating global approaches to recordkeeping. Parliaments themselves should also intensify this co-operation and share their best practices, experiences and challenges in dealing with the COVID-19. International organisations such as the OECD and its Global Parliamentary Network have a pivotal role to play during these unprecedented times. They help to facilitate pertinent policy dialogues on important socio-economic matters and provide us with advice and recommendations, so that parliaments can use them as guidelines to improve the situation and/or propose to its governments. To use the example of the Indonesian Parliament view that the implementation and achievement of the Sustainable Development Goals (SDGs) cannot be postponed amid the COVID-19 pandemic, I restate the fact that the SDGs should be the measure for parliaments to prevent trade-offs in this moment of crisis, for example, between the economy and health, in any laws or programmes. It is also important to emphasise that the entire Indonesian House of Representatives, including those in the commissions, are working to support the implementation and achievement of the SDGs, supporting resolutions relevant to SDGs and that are in the public interest. This is also the time for us as Nigerians, and as Africans, to open our eyes and realise the importance of improving individuals' social and economic rights – especially the poor and vulnerable – such as clean water and sanitation (SDG 6) and economic growth tied to decent work (SDG 8). It is clear that fighting COVID-19 requires people to have clean water and sanitation – and not everyone has access to it. Much of our nation’s willingness to learn, embrace and engage with the plethora of ongoing initiatives that have so positively contributed to the building and delivery of timely, appropriate and affordable care concepts and pathways in Nigeria today, is arguably attributable to the overarching and consistent primary theme of ‘accessibility’ these tremendous efforts were primarily built upon. A fearlessly competent, responsible and promising generation have successfully ensured that accessibility remains a true ethos and the pertinent undercurrent when shaping and delivering an intentional and undeniably imperative standard of care. Sadly, their efforts have now rather tragically arrived at a potential point of trepidation. These findings should fill every stakeholder with encouraging zeal, renewed passion and an inexplicable sense of determination to work towards establishing tangible, long-term solutions for this pandemic and beyond.  We must continue forward – and ensure that a path towards the sustainable replenishment of much needed resources is assured. To date, the responses and levels of engagement from members of society coupled with repeated statistical confirmations of increased success following the introduction of a number of health and wellbeing initiatives, further echoes my sentiments and of many others. Now more than ever before, the nation requires a firm continuation of a well-functioning, culturally and economically appropriate primary health and basic education system – one which must remain accessible to all and for all, in all its entirety. With this being said then, the most poignant way of ensuring that this can and should be made possible, is to maintain the level of financial input that 9th NASS initially committed to and maintained in the lead up to this unfortunate outcome. In light of the recent COVID-19 outbreak, and while duly and empathetically acknowledging the economical setbacks that such a global pandemic has birthed, it is with the greatest of respect, care, honour, but also pride for all that we as a nation have achieved, that I make mention of this decision being a very important one. From our global counterparts and stakeholders, right through to a growing community of invested and daily-committed healthcare and education facilitators here in our nation of Nigeria, the transitions and great strides made and being reflected by way of national and international policy, practice and (societal) position are going from strength to strength. Many of you have responsibly embarked on a lifelong journey which has continuously proven to be of great societal, medical and generational benefit. This is particularly evident statistically. With health, as with education, the access to upholding and maintaining it, and human engagement really do go hand in hand: the intentional attitude and efforts our nation employs daily in a bid to truly care, educate and continue advocating for a significantly positive quality of life for all, is in actual fact, entirely dependent on the resources being made available to professionals and those within their care. Access to affordable healthcare and education then, should be a precise and continuous embodiment of the primary intention behind the service and its delivery. I believe that the truest way in which we can continue to facilitate, impact and inform attitudes and approaches to healthcare and education in our nation, in a way that evidently works well, is to truly uphold our level of (physical and financial) input. Only then, can we truly make it holistically accessible. Last week, I signed my name to join the #GlobalGoalUnite call for urgent investments and actions. Join me, by signing the campaign here, too: www.globalcitizen.org  

FROM June 20th, 2020

There are more displaced peoples in Nigeria—over two million—than the populations of Ilorin, Abuja and even Benin City. The scale of this situation in Nigeria is a tragedy for our people and our economy. At home in Nigeria, the conditions being faced by our population of concern are an increased cause for alarm and focused action within our COVID-19 response strategies – Nigeria is facing immense humanitarian and protection challenges due to the ongoing insurgency in the North East. The conflict has caused grave human rights violations, impacting particularly on the most vulnerable civilians. According to the UNHCR, as of May 2020, there are 2,046,604 internally displaced persons in the Northeast region, with 90% of the displacements in Borno, Adamawa and Yobe states. Outside of the Northeast an estimated 578,119 people are displaced due to banditry and farmer-herders conflict. There are 61,361 registered refugees and asylum seekers as of April 2020, with 60% located in Cross Rivers, 21% in Taraba, 12% in Benue and 6% registered in Lagos whom are classified as urban refugees and asylum seekers. There are a further 292,513 Nigerian Refugees in our neighbouring countries of Niger (55%), Cameroon (40%), and Chad (5%). View the map>> In summary, as of May this year, the total number of people attributed to Nigeria’s existing population of concern stood at 2,107,965. More than 61,000 were registered as refugees and asylum seekers, and the significant remainder originating from neighbouring nations were identified as internally displaced persons (IDP). The spectrum of challenges that refugees and displaced persons face is very broad: they may be traumatised, having lost homes, livelihoods and identities. However, when the host communities have strong systems in place, the suffering is mitigated, and the road to recovery can begin. I have always felt that refugees should have health rights guaranteed in any host location, and health-enhanced certifiable identities. The United Kingdom, Greece and Turkey support the health of refugees effectively, with the help of the World Health Organisation, which works closely with government health departments to provide culturally and linguistically sensitive health services to refugees. That’s why in February I was pleased to attend the launch of the Lancet Migration, a collaboration of researchers in migration and health who are building evidence to drive policy change in this area. I’ve been involved with helping to provide aid to many refugee camps in Northern Nigeria, and I’ve come to the understanding that ensuring health care should be standard in supporting the dignity of displaced persona. On World Refugee Day today, I commit to working with Lancet Migration, and call for attention on the rights of refugees in relation to accessibility to health care.

FROM June 1st, 2020

This year marked the start of the United Nations' Decade of Delivery, where we were promised that things would change for the empowerment of women and girls. Armed with research to prove how much better off our world would be with the rights of women and girls realised, we in the global advocacy community declared that it is well past time to start living in a gender equal reality.

But instead of keeping our promise to protect and empower women and girls, in Nigeria in 2020, we are still burying them.

Vera Uwaila “Uwa” Omozuwa was a 22-year-old student at the University of Benin who went to her church to read in a quiet space when she was brutally raped. The viral photos of her bludgeoned body have reverberated around the world, adding fire to the flames of the conversation about brutality, violence and lack of a framework for social justice and responsibility; she died of her injuries on 30 May. In Lagos, 16-year-old Tina Ezekwe was trying to get on a bus when a drunken, corrupt police officer attempted to bribe the driver, leading to a sloppy confrontation and shots fired: the bullet pierced through the upper left side of her lap. The battle to save her life lasted for two days, and she died on 28 May. In Jigawa, Jennifer, a twelve year old girl was allegedly raped by 11 men, who have been arrested. In 2018, promising young girls Anita Akapson and Linda Angela Agwetu were murdered in similar, senseless fashion, again by trigger-happy officers around their own homes. These cases spotlight what has been blindingly evident since the forced abductions of the Chibok and Dapchi Schoolgirls: we are failing our women and girls. Last year I was honoured to join the International Conference on Population and Development, full of hope to deepen Nigeria’s consultations on gender. I called to build political commitment from leaders and policymakers to speak out, condemning violence against women. But with the heartless, thoughtless violent deaths of Uwa and Tina it is clear that we have thus far failed to engage leaders and policymakers to implement meaningful mechanisms to protect them. I had declared in 2018, after the death of another innocent girl victim of sexual and gender based violence, Ochanya,  that we were standing on a gender precipice from where good actions could flow, if together, we determinedly took the right actions to protect women and girls. I declared that I envisaged a world where everyone can decide freely when to have children, and has the information, education and means to do so. With sexual and reproductive health care deemed “non-essential” during the COVID-19 pandemic, and consequent restrictions implemented all over the world, we have failed to protect women’s rights to her own body. At the United Kingdom-France consultations on the Prevention of Sexual Violence Initiative last year, we said with such hope that we would uphold the United Nations Security Council's Resolution 1325 on women peace and security. While at the African Women Leadership Network and the African Union with UNWomen last year, we vowed to invest in women's groups, to ensure that we give women the leadership opportunities to better shape their own futures, and we did. But when globally, only 1% of gender equality funding is going to women's groups, we have failed to invest in women. At the Commonwealth of Nations last year, we made a promise of No More Violence, yet, here we are, from our leaders, and right down to our grassroots, failing women and girls. Frankly, I am outraged. The gruesome deaths of Uwa and Tina are a visceral notice of our failure in Nigeria, and that’s why I am joining the WACOL Tamar SARC and Social Intervention Advocacy Foundation to call for radical reform of our police, to end the impunity of sexual violence against women and girls. In the name of all our global and national commitments to women and girls, the Nigerian state must make systemic changes to protect our young girls. Uwa and Tina’s lives will not be lost in vain. Join the cause>>

FROM May 29th, 2020

The recent stories about violent police killings of African Americans are pulling at my heartstrings. My expertise is in child and maternal health and wellbeing in Africa, and police brutality in the United States may seem like it is 6,218 miles (the distance from Lagos to Minneapolis) away from my wheelhouse. But that would be denying the reality that we Africans are a global community united by the colour of our skin and ancestries that have been altered by systems of oppression that have spanned and scrambled our societies for generations, and which we have, collectively and individually, climbed to overcome.

I care for mothers and children in Nigeria and Africa because when maternal mortality is so high and when we see black people dying of COVID-19 at a far higher rate than white people, it is of existential importance to nurture the forthcoming generations of our people. As Ta-Nehisi Coates once wrote, black people love their children with a kind of obsession, because black children are endangered.

The video of George Floyd, pleading for his life from under the knee of a casual police officer; the story about the EMT nurse Breonna Taylor, shot a shocking eight times after a misunderstanding; that Ahmaud Arbery was practically hunted by mistaken neighbours while out for a jog is a stark reminder of our peoples' endangerment. With all of its power and functioning bureaucracies, the U.S. —held up as the pillar of democratic practice globally—has the means, the wherewithal, and the opportunity to signal to the world that it values black lives. I am given an ounce of relief in the fact that the U.S. Justice Department said it would make a federal investigation into Mr. Floyd's death a "top priority." However more must be done through education, investment and empowerment. In the face of mounting police brutality in my own country, in 2019, I encouraged the youth-led END SARS Movement in Nigeria, initiated by the Social Intervention Advocacy Foundation. Their aim was to establish much-needed partnerships between the key security agencies, academia and industry practitioners for research-based solutions. They have advocated for operational and governance models to be developed—to put a stop to extrajudicial killings of young people. Since then, some best practices have been adopted and shared, as well as SIAF joining a national security cooperation in support of peace and stability. The work continues as they liaise with national government security agencies and to facilitate them in improving operational standards and good governance, and as they help to maintain a peaceful and tranquil society. Riots are not an answer - to enable change, stakeholders know that they must constantly undertake methodical studies of endemic and emergent problems in the principles and practices of law enforcement policing, intelligence operations, maintaining homeland security, transnational security and trafficking, corruption and the criminal justice system and promotion of science and technology. Reformation in correctional services and forensic sciences, being an integral part of the justice system, must also be researched thoroughly. We as Africans and African diaspora must work to instil the understanding that soft phrases such as 'race relations' oftentimes hide the fact that racism for so many of us is corporal. The failure of health systems to protect and cure people of black and minority ethnicities around the world means that racism does manifest through organ failure via COVID-19. The failure of police hierarchies to ensure its ranks are careful, and the failure of education systems to teach its pupils about other cultures is manifested through bodies bleeding out from gunshots. Some are calling for African leaders to summon their local US ambassadors to speak out against these injustices, and in the name of our community, I join in that call. We must unite our global African community around these lost souls, who have been killed extra-judicially, to proclaim the might and meaning of human rights and social significance of our people.

FROM May 26th, 2020

As we mark Africa Day, I am encouraged by the milestones we have achieved, standing together as one united Africa, towards providing equity in health access since the Alma Ata declaration of 1978.⁣ ⁣ Personally, a high point for Nigeria was in 2018 when Nigeria's National Assembly, chaired by my husband H.E. Dr Bukola Saraki MBBS, CON, helped establish the Basic Health Care Provision Fund. It was a key and catalytic step towards achieving Universal Health Coverage for our citizens.⁣ ⁣ As the coronavirus pandemic puts health systems to unprecedented tests, I call on our African leaders, of governments, of policies, and of innovative actions, to rise to the challenge of the #AfricaWeWant. We must accelerate investments and actions to meet the health needs of our citizens by strengthening primary health care services with efficient diagnostics, referrals and treatment. Let's walk the talk for primary health care and wellbeing.⁣ ⁣ As we stand together in rallying the right resources to combat COVID-19, I also call for the reinforcement and replenishment of the 2001 Abuja Declaration—a pledge made by the African Union, standing as one, promising to increase their health budget to at least 15% of the state's annual budget. The World Health Organisation reported in 2010 that only one African country had reached that target. Today in 2020, we must replenish and reinforce those promises to ensure that every citizen can access an efficient system of quality health.

FROM May 20th, 2020

During a normal year I would be traveling to the World Health Assembly this week, but this year I joined state leaders and world-renowned experts virtually from our homes, in light of the COVID-19 pandemic. Still, the spirit is evident: global collaboration on the state of our world’s health has never in our lifetime been more necessary.

During this week's World Health Assembly, I am calling on global leaders, particularly in Nigeria and across Africa, to make commitments to rebuild and reinforce every element of primary health care.

  This is backed by the decades I have worked on maternal, child and family health throughout Nigeria. Primary Health Centres (PHCs) are mostly located within communities, and much of Nigeria and Africa remains rural. With the majority of Nigeria’s population living in these rural communities, and a recognition of the strong indications of community transmission of the virus, PHCs should serve as an important link in the management of the COVID-19. In 2015, I successfully facilitated a maternity referral standard primary health centre at Eruku Cottage Hospital in Kwara State, and saw the benefits of a prompt pathway from diagnostics to treatment and care.⁣   [video width="640" height="360" mp4="https://toyinsaraki.org/wp-content/uploads/2020/05/2e03506b-bae4-4210-a566-fe2f122bbc54.mp4" autoplay="true"][/video]   Similarly, from my leadership role chairing Nigeria's Civil Society Coalition's Primary Health Care Revitalization Support Group to the 8th National Assembly, which successfully advocated for the Basic Health Care Provision Fund, I know that achieving universal health coverage will not rest upon one single static action, but on the spectrum of interventions and initiatives; from water, sanitation and hygiene standards in healthcare facilities to breastfeeding education and training for healthcare workers. In a country as large as Nigeria, resilience throughout the whole nation’s system was always going to be necessary if we were going to be able to tackle critical health emergencies in fragile settings, such as in the North East. Today, even the strongest regions are sorely tested, and that is why a strengthened primary health care system is imperative as the foundation to achieve health for all. Support for PHCs should be a focal point for investment, as we coordinate our responses to the pandemic. It is only by strengthening capacity and concrete frameworks at primary levels of care and education services that we can build the resilience to cope in times of crisis, restore health and prosperity, create healthy futures and improve the wellbeing of citizens in the long-term. Read more on Wellbeing Foundation Africa>>

FROM May 8th, 2020

I am excited to announce that Wellbeing Foundation Africa is partnering with U.S.-based company Fortify to address iron deficiency: the major underlying cause of maternal deaths during childbirth in developing countries. ⁣ I started working on improving iron deficiency in Nigeria in 2014 with a programme called Green Food Steps. I worked with Unilever’s biggest brand Knorr to educate women and daughters to practice new, nutritious cooking habits. ⁣ But when I met the Fortify team to talk about a partnership last year, I was struck by how elegant yet practical a solution they have for iron deficiency anemia: they help add iron to ingredients that make up everyday meals—such as tomato paste. Tomato paste is already built into the food supply, it’s a big part of the meals every African eats; that’s why they’ve worked to produce 20 million sachets of iron-fortified tomato paste varieties in Nigeria monthly. Implementing more iron in our food staples is not just a compassionate move to improve maternal health: it’s economically beneficial, too. According to the World Health Organization, timely treatment of iron deficiency anemia can ultimately raise national productivity levels by as much as 20%. ⁣ That’s why I’m so excited to engage First Ladies and women leaders—because of the impact they bring to women, families and communities in improving maternal health outcomes—but also policymakers across Africa to accelerate efforts to eradicate iron deficiency. Read more on Wellbeing Africa. 

FROM May 4th, 2020

Toyin Saraki hails midwifery professionals as the world marks International Day of the Midwife 2020; Launches ‘We Must Applaud Midwives with WASH’ campaign

Toyin Saraki has hailed International Day of the Midwife, marked today around the globe, as “the most momentous day in a century for midwives.” Saraki, who is Global Goodwill Ambassador for the International Confederation of Midwives (ICM) and Founder-President of the Wellbeing Foundation Africa (WBFA), has marked the day by paying tribute to midwives around the world and by launching a new campaign to improve the safety of their working conditions. Saraki commented: “2020’s International Day of The Midwife is remarkable in many respects – and is truly momentous, as it takes place in the first ever Year of the Nurse and the Midwife. This year has been designated by the World Health Organization as a year-long effort to celebrate the work of midwives and their colleagues, highlight the challenging conditions they often face, and advocate for increased investments in the workforce.” “While we celebrate the work of midwives, this is also a solemn day, as we pay tribute to midwives who have lost their lives in the course of their duties, not only during the current COVID-19 crisis but also those in recent years who have paid the ultimate price in conflict areas. Whatever the circumstances, however dangerous, midwives continue to provide a continuum of care, standing beside women at their most vulnerable moments. I know that I will have many midwives, including close friends, in my prayers today.” “Infection prevention and control is at the top of the global agenda right now. Midwives have led on this since 1840 – if not before – when physician Ignaz Semmelweis worked with midwives to promote water, sanitation and hygiene (WASH) on maternity wards. I am therefore proud today to launch the ‘We Must Applaud Midwives with WASH’ campaign, to highlight that whilst we should applaud midwives we also need to ensure that they have the conditions they need to work safely and deliver for women, babies and communities. WASH plays a vital role in stopping disease transmission yet two out of five healthcare facilities still lack hand hygiene facilities at points of care. I am promoting ten immediate actions which should take place in all healthcare facilities to respond to COVID-19 and protect midwives, their colleagues and patients.” “Midwives are champions of women’s rights; but can only be effective if their rights are also secure. This includes the right for every midwife—and all health workers—to decent work and a safe and dignified workplace. Saving lives does not mean a midwife should risk her own. I continue to advocate for whole-system support, which means providing midwives with the adequate tools, equipment, and medicine to provide the full scope of timely, high-quality care, and the capacity to carry out the WHO-recommended 8 antenatal visits. We should all take up the call of the International Confederation of Midwives to celebrate, demonstrate, mobilise and unite with midwives.” Toyin Saraki is also Special Advisor to the World Health Organization Independent Advisory Group to the Regional Office for Africa, a member of the Concordia Leadership Council and was named by Devex as ‘Global Health for All Champion. Toyin Saraki is promoting the following ten Immediate WASH Actions in Healthcare facilities to Respond to COVID-19: 1. Handwashing: Set up handwashing facilities, like a bucket with a tap with soap, throughout the facility. Prioritise the facility entrance, points of care and toilets, as well as patient waiting areas (and other places where patients congregate). If the facility is piped, repair any broken taps, sinks or pipes. 2. Water Storage: Consider the water requirements to perform WASH/IPC activities with an increased patient load. If inconsistent or inadequate water supply is a concern, increase the water storage capacity of the facility, such as by installing 10,000L plastic storage tanks. 3. Supplies: Solidify supply chains for consumable resources, including: soap (bar or liquid), drying towels, hand sanitiser and disinfectant. Ensure cleaners have Personal Protective Equipment (PPE) for cleaning. If ingredients are available locally, produce hand sanitiser at the facility (or at district-level) – see WHO protocols. 4. Cleaning & Disinfecting: Review daily protocols, verifying based on national guidelines or global recommendations for resource-limited settings and noting additional levels and frequency of cleaning in clinical areas with high numbers of COVID-19 cases, including terminal cleaning. Ensure adequate supplies of cleaning fluids and equipment, making allowance for additional cleaning requirements. Ensure handwashing stations and toilet facilities are cleaned frequently. 5. Healthcare Waste Management: Strengthen healthcare waste management protocols by making sure bins are located at all points of care, that they are routinely emptied, and waste is stored safely. 6. Staff Focal Points: Assign staff member(s) – cleaners, maintenance staff, or clinicians -- whose job it is to oversee WASH at the facility, including: refilling handwashing stations, auditing availability of supplies in wards, reporting on WASH maintenance issues, monitoring cleaning and handwashing behaviours of staff and communicating updates to the director daily. 7. Training: Organise training for all staff on WASH as it relates to their role at the facility, including a specific training for cleaners based on the protocols reviewed above. 8. Daily Reminders: Remind staff of WASH protocols during morning meetings. Post hygiene promotion materials throughout the facility, particularly next to handwashing facilities. 9. Hygiene Culture: Encourage a culture of hygiene at the facility. Emphasise that all staff members, including cleaners and maintenance staff, are part of a team working to prevent the spread of infection. Recognise individual WASH champions in the HCF. 10. IPC Team: Work with the Infection Prevention and Control (IPC) team at the facility to make sure efforts are reinforced and aligned, avoiding duplication. Encourage WASH focal points/partners to participate in IPC meetings. Coordinate WASH/IPC activities based on plans to isolate COVID-19 patients. More on International Day of the Midwife can be

FROM April 28th, 2020

Together, we are facing a global health crisis. Each day, as the death toll due to COVID-19 rises, people in governments, institutions, hospitals, communities and households around the world are having to navigate unprecedented sacrifice and hardship – making decisions with profound effects on their lives and livelihoods. As a collective network of girls, women, advocates, and allies working in global development, we stand together to encourage global collaboration to combat COVID-19. Only by working together can we ensure that no one is left behind in our response to the pandemic. Our focus now must be on supporting vulnerable communities and the most vulnerable people within our communities – in the spirit of solidarity, but also for our own protection. This includes girls and women who are now at a higher risk of gender-based violence and rights abuses, and at-risk groups (including people who have disabilities or identify as LGBTQIA) who are being targeted or are unable to access routine services. At a time of ever-increasing social distancing, there has never been a more crucial need for community and selfless leadership. The World Health Organization’s continued focus on saving lives and supporting and protecting the most vulnerable of us will play a pivotal role in our recovery. Now more than ever, countries need to unite behind a strong WHO – sharing knowledge, strategy, technical resources and financial investment to defeat the global threat we all face. We must make no concessions for blame, politicisation or racism in developing an inclusive and effective solution to this crisis. Across the world, we see the power of community and shared resources, as individuals step forward to support each other. Our heroes – the predominantly-female health workforce, working day and night to serve our communities and unite us – have demonstrated that cooperation is to mitigate the impact of COVID-19. In such challenging times, it is crucial that we overcome any efforts to divide us. Join us by signing on

FROM April 15th, 2020

For better health security, it's time to end gender biases that keep women out of global health leadership positions

Whenever a high-profile health emergency breaks out or an influential commission needs experts, it seems global health reverts to the default of delivered by women, led by men. The message seems to be Health emergency! Step aside, ladies – men coming through. Although women make up 70 percent of the global health workforce, and although they work at all levels in health security—from the front lines of healthcare, to research labs, to health policy circles – they have not been represented equally in decision-making bodies that are informing our COVID-19 responses. A presidential tweet showed the first iteration of the U.S. Coronavirus Task Force was composed entirely of men. In January, just five women were invited to join the twenty-one member WHO Emergency Committee on the novel coronavirus. Unrelated to this decision, UN Secretary General Antonio Guterres made a strong public statement a few weeks later. "Women’s inequality should shame us all. Because it is not only unacceptable; it is stupid," Guterres said in February. "Only through the equal participation of women can we benefit from the intelligence, expertise and insights of all of humanity."
[caption id="attachment_1085" align="aligncenter" width="640"] UN Secretary-General Antonio Guterres at a press briefing on the eve of an International Conference on the future of 4.6 million Afghan refugees living in Pakistan—in Islamabad on February 16, 2020. REUTERS/Saiyna Bashir[/caption]
There is a huge contingency of global health experts who are also women, but they are not being called upon to lead responses to this global health emergencyand this puts us all at risk. Ignoring women’s expertise and perspectives undermines health security for everyone.

Six reasons why gender matters in global health security:

NUMBER ONE: Strong COVID-19 responses draw leaders from the entire talent pool. Women are 70 percent of the global health workforce but hold only 25 percent of senior decision-making roles. Excluding women from decision making robs health systems of the knowledge and expertise of the health workers who know these systems best. In America, which has a mostly-male Coronavirus Task Force, women have become the majority of young doctors and epidemiologists. Including women (and women from diverse groups and geographies) is about effectiveness and saving lives, not just representation. Diverse leadership groups make better, more informed decisions. NUMBER TWO: Women are needed to fill the global shortage of health workers, which limits our ability to respond to health emergencies. As the majority of the global health and social workforce, women currently deliver health care to around five billion people. Female health workers are central to the response to any epidemic. The women health workers on the front lines of health systems do not want to be sentimentalized or celebrated as martyrs. They want to lead, they want to be listened to and they want the means to do their jobs professionally, safely and with dignity. Around half of all health workers are nurses and midwives. As the International Year of the Nurse and the Midwife, what better time than 2020 to harness the expertise and leadership potential of nurses and midwives? A 2019 WHO report concluded, however, that although women are the majority in the health and social workforce, they are clustered into lower status, lower-paid (and unpaid) roles and frequently subject to discrimination, bias and sexual harassment, which can cause them harm, limit their career growth, and cause attrition. With a projected global shortage of around forty million health and social workers by 2030—eighteen million needed in vulnerable low-income countries alone—the world must invest urgently in decent work for female health workers and enable them to fulfil their potential in all areas, including leadership. That is our best chance of retaining female health workers and scaling up the global health workforce to meet demand and the challenges of epidemics and pandemics. NUMBER THREE: Women’s political voices strengthen health systems for better health security—now and in the future. Women do not have an equal say at political level in most countries on critical issues like health budgets and universal health coverage. Globally, women are only 24 percent of the parliamentarians who make decisions on health systems funding and coverage. If women did have an equal say in political decisions on health, research suggests health systems would be stronger as female parliamentarians are more likely to give [PDF] greater priority to health. This matters now more than ever; countries with strong national health systems and universal health coverage are better able to cope with outbreaks and other health emergencies. Without strong health systems that make care affordable and accessible, the most vulnerable—older people, pregnant women, the homeless, the poor, and those with pre-existing conditions and poor health status (the majority of whom are women)—will be missed by critical outbreak response activities such as widespread testing and treatment. Ultimately, this hinders containment of infectious diseases like COVID-19.
‘Countries with strong national health systems and universal health coverage are better able to cope with outbreaks and other health emergencies’
[caption id="attachment_1086" align="aligncenter" width="640"] Afghan parliamentary candidate Suhaila Sahar during an election campaign in Kabul on October 8, 2018. Research suggests female parliamentarians are more likely to give greater priority to health. REUTERS/Omar Sobhani[/caption] NUMBER FOUR: Women and men have different, socially defined roles—and this perpetuates inequalities and weakens health security. Women carry out the majority of care for sick family and community members, and that puts women at greater risk of contracting infections like COVID-19. At the same time, women’s role as household caregivers can be leveraged for better health promotion and disease prevention/management at the family and community levels—but only if they are empowered with accurate information and the means to support the sick. COVID-19 was initially associated with a particular food market in Wuhan, China, where it is likely that the majority of traders were women. After the SARS outbreak in China in 2002, women in the same professions could have been vital allies in the cultural and behavioral change needed to avert a new viral outbreak—but clearly, this opportunity was missed. In many country contexts women are less educated than men, have less access to digital technology, and are generally overlooked as potential change agents. NUMBER FIVE: Biology and gender determinants of health affect the way disease is transmitted and progresses. Data are still being collected and analysed, but early figures from the COVID-19 outbreak in China show higher mortality among men than women, especially in older age groups.
‘Early figures from the COVID-19 outbreak in China show higher mortality among men than women, especially in older age groups’
One hypothesis is that higher smoking rates by men leaves them more susceptible to respiratory viruses like SARS-CoV-2, which causes COVID-19. There are other gender-related aspects of the disease that are virtually unknown—for example, we still need to understand how COVID-19 affects pregnant and breastfeeding women in order to protect both women and the unborn child. A different virus, Zika, if contracted by a pregnant woman, does serious harm to the unborn child. Nothing similar has been reported with COVID-19, but this example show that it is critical that policy responses to epidemics examine the impact of both biological sex and the gender determinants of health. [caption id="attachment_1087" align="aligncenter" width="640"] A man wearing an N95 mask smokes in Singapore on February 23, 2020. Higher smoking rates among men may leave them more susceptible to respiratory viruses and account for higher COVID-19 mortality. REUTERS/Feline Lim[/caption]
 
NUMBER SIX: Global health rests on the foundation of women’s unpaid work. Here’s an uncomfortable fact: women in health contribute an estimated 5 percent to global GDP ($3 trillion), of which almost 50 percent is unrecognised and unpaid. Some of the world’s poorest women and girls are effectively subsidising health systems and missing out on opportunities to enter education and the formal labor market. This is not only inequitable—it weakens global health security everywhere. Infectious diseases like COVID-19 do not respect national borders, and we are all only as safe as people in the weakest national health system. Women’s unpaid work needs to be recorded, redistributed (within the family and community) and rewarded, with women enabled to transition into paid formal sector employment.
‘We cannot fight a global health challenge like this by drawing from just half the talent pool’
This week, Women in Global Health was proud to launch COVID 50/50, our campaign for a more inclusive pandemic responses, which includes fives asks for more gender-responsive health security. These asks build on Operation 50/50—a crowdsourced list of women health security experts, designed to be a resource for organizations looking for health security experts and media commentary on COVID-19. The current pandemic makes it clear: it’s time to acknowledge that the gender stereotypes and bias keeping women out of leadership and decision making put us all at risk. We cannot fight a global health challenge like this by drawing from just half the talent pool. We cannot win this fight with one hand tied behind our backs.

FROM April 15th, 2020

The world is hurting, and we need the WHO now more than ever before. Millions are suffering and misinformation is spreading, with fear and even racism impeding mechanisms for an effective response. Countries and communities are acting both together and apart. Right now, every community needs information based strictly in science and supported with the benefit of a global perspective. The world needs a well-functioning global organization designed to facilitate international coordination. We need the WHO, our standard-bearer in unprecedented times for an unprecedented virus. The pandemic is a stark reminder that humans are connected, and that what happens in one country can impact the everyday lives, social fabrics and economies of countries far away. Human connectivity holds power: the positive impact of our collective will to physically distance from one another alone shows what power we hold. Guided by the heart beat of world health—the WHO—together we have pulled resources, research, and we have made a global effort to benefit the health of all of us. We are grateful for those who have recovered due to the efforts of indefatigable health workers who have detected, tracked, traced and treated the affected, even as we have mourned the lives and livelihoods that we have lost. Together we must continue to marshal support to combat this virus. We hold the hope for better days ahead.

FROM March 25th, 2020

World Tuberculosis Day 2020 – It Is Crucial To Deepen TB Advocacy And Actions To Ensure Tuberculosis Does Not Become Totally Invisible During The COVID-19 Pandemic – Toyin Saraki, Founder, Wellbeing Foundation Africa I was recently following the research findings of Madhukar Pai, Canada Research Chair of Epidemiology and Global Health at McGill University, Montreal Canada, where he called for a damage control plan for tuberculosis during the ongoing COVID-19 Pandemic. As the coronavirus COVID-19 pandemic sweeps the world, the global health community working to fight TB have growing anxiety about what this pandemic will do to a much older infectious killer - tuberculosis (TB). We know from the Ebola experience that epidemics can disrupt even basic services such as routine immunization. No doubt, COVID-19 will adversely affect all routine health services everywhere. But TB services is might be one of the biggest casualties. Why? Even before COVID-19, TB had a notorious track record as a ‘Captain of the Men of Death’. TB kills 4000 people each day, and 1.5 million people each year. TB is the leading killer of people living with HIV/AIDS. An estimated 10 million people developed TB in 2018, and nearly half a million people developed drug-resistant TB (DR-TB). COVID-19 is a crisis of social solidarity and social investment. This applies to TB as well. It is crucial to deepen TB advocacy and actions to make sure TB does not become completely invisible during the COVID-19 pandemic. People are leaving no stone unturned to stop the coronavirus pandemic. If we show even half of this dedication towards ending TB, we can stop millions from dying from a preventable and curable disease. I stand in solidarity with the Stop TB community as we support people affected by COVID-19. This World TB Day we support the fight against the new pandemic, share our lessons, experiences and tools so that united we can defeat it. We want to remind global leaders the urgency to invest in better and more resilient health systems, today more than ever we realise the need to end endemics like TB or COVID-19. To fight COVID19, we can use the tools needed to End TB: infection control, artificial intelligence, x-rays, contact tracing, telemedicine and psycho-social support. Years of under-investment made tuberculosis and its drug resistant forms the biggest infectious disease killer with over 4000 deaths per day. We can’t afford to repeat these mistakes and be unprepared for pandemics like COVID19. Most TB survivors have gone through the isolation, fear, discrimination and stigma that we are facing with COVID 19. Let’s hear their voices and learn resilience from them. It’s Time To End TB. It’s time to recognize that people with #TB are vulnerable to COVID19, including prisoners, migrants, people living with #HIV, and those who are malnourished. Healthcare workers are at the centre of the fight against diseases such as tuberculosis or COVID-19 - While most of us are at home, social distancing, the health workers leave their houses and families to ensure that people with TB get diagnosed, treated and cured and also battle COVID-19. I appreciate and applaud their efforts as frontline health heroes. I join the Stop TB Partnership in calling on global leaders to join forces to protect people affected by TB and especially vulnerable populations from #COVID19. It’s time to ensure we #LeaveNoOneBehind #ItsTimeToEndTB

FROM February 9th, 2020

Along with the global health community, The Wellbeing Foundation Africa has taken note of the WHO declaration of a public health emergency of international concern over the global outbreak of the Novel Coronavirus. WHO has identified 13 top priority countries (Algeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia) which either have direct links or a high volume of travel to China. “To ensure rapid detection of the novel coronavirus, it is important to have laboratories which can test samples and WHO is supporting countries to improve their testing capacity. Since this is a new virus, there are currently only two referral laboratories in the African region which have the reagents needed to conduct such tests." “However, reagent kits are being shipped to more than 20 other countries in the region, so diagnostic capacity is expected to increase over the coming days. Active screening at airports has been established in a majority of these countries and while they will be WHO first areas of focus, the organization will support all countries in the region in their preparation efforts" "It is critical that countries step up their readiness and in particular put in place effective screening mechanisms at airports and other major points of entry to ensure that the first cases are detected quickly” The Wellbeing Foundation Africa commends and thanks the thousands of courageous frontline heroes, the frontline health professionals who are working around the clock in affected regions to treat the sick, save lives and bring this outbreak under control. The Wellbeing Foundation Africa continues to advocate and urge, particularly in Nigeria which is currently responding to a Lassa Fever outbreak in over 11 states, that investment in a skilled and sustainable, locally led frontline health workforce able to detect, report and respond to threats and deliver quality health services including water, sanitation and hygiene essentials for infection prevention and control, is crucial to building health systems resilient to outbreak.